Hope for a new knee: a qualitative study on decision-making process for total knee replacement in Taiwanese women

Abstract

Abstract Background: Total knee replacement (TKR) can alleviate knee osteoarthritis (OA) effectively. Many women undergo TKR; however, research on women’s decision-making process remains scant. This study aimed to explore the decision-making process for undergoing TKR among Taiwanese women. Methods: A qualitative approach was used. Through purposive sampling, a total of 20 women aged > 40 years with knee OA undergoing TKR were recruited from a teaching hospital of Northern Taiwan. Data were collected 3–5 days and 6–8 weeks after TKR through in-depth interviews, observation, and field records and analyzed with constant comparative analysis. Results: “Hope for a new knee,” the core theme for TKR-related decision-making, comprised three stages (including six themes): before decision (impacts of pain and seeking nonsurgical methods), decision (intrinsic and extrinsic motivation), and after decision (assessing physical function and achieving the golden phase of rehabilitation). Conclusion: Women expected to have a new life after undergoing TKR. Impacts of pain and concern of becoming a burden on the family were main factors influencing the Taiwanese women’s decision for a TKR. These women strove to overcome difficulties related to post-TKR rehabilitation. An individual teaching programs and psychological support for women is imperative. The findings of women’s values and preferences for a TKR surgery will be helpful to develop an interventional decision support for shared decision-making.