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Journal article

Personal meanings in the construction of need for total knee replacement surgery.

Abstract:
This study explores patients' personal meanings of knee osteoarthritis (OA) and total knee replacement (TKR). Personal meanings are important because decisions regarding the need for TKR do not seem to be explained by symptoms alone. A total of 18 semi-structured interviews were conducted with a purposive sample of respondents who were listed for TKR at one UK specialist orthopaedic hospital, and who had lower than average disease burden according to standard quantitative criteria. Data were analysed using interpretive phenomenological analysis. Several themes related to need for TKR emerged: adoption of the medical model, a person's social network, pain, functional loss, feelings of vulnerability, dependency, low mood and fatigue, ideas related to disease progression and expectations of TKR. Results suggest that the decision to undergo TKR is not related to symptoms alone, but to personal meanings. Some of these personal meanings may not be useful in accurately assessing the need for TKR, and may result in mis-targeting of treatment. It is important for health professionals to explore and tackle personal meanings when considering treatment. In particular, it may be important to consider gender differences that may influence when men and women are listed for TKR. For example: women may be less likely to discuss treatment options with their doctor; they may be more likely to have heard negative examples of TKR from friends or family; they may be more likely to discuss pain and mobility issues than activities requiring higher function; and they may be more likely to discuss the effect on their mood and the emotional impact of OA.
Publication status:
Published

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Publisher copy:
10.1016/j.socscimed.2005.11.054

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Role:
Author


Journal:
Social science and medicine (1982) More from this journal
Volume:
63
Issue:
1
Pages:
43-53
Publication date:
2006-07-01
DOI:
EISSN:
1873-5347
ISSN:
0277-9536


Language:
English
Keywords:
Pubs id:
pubs:108903
UUID:
uuid:d87ed7af-1464-4e5c-8c0f-19645e105559
Local pid:
pubs:108903
Source identifiers:
108903
Deposit date:
2012-12-19

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