title: Influences on individuals with osteoarthritis in deciding to undergo a hip or knee joint replacement: a qualitative study.
abstract: OBJECTIVE
  Osteoarthritis (OA) of the hip and knee is one of the major long-term health conditions. At the end-stage of the disease, a hip or knee replacement may be necessary. Yet, deciding to undergo a total joint replacement (TJR) due to OA may be a difficult decision for individuals. We conducted a study to elucidate the factors that influence whether or not individuals with OA decide to undergo a hip or knee replacement.
  
  
  METHODS
  A qualitative study nested within a longitudinal study (n = 268) that was exploring the management of OA. We interviewed a purposive sample of individuals (n = 27) with OA referred for consideration for TJR.
  
  
  RESULTS
  Participants were aged 49 to 89 with hip or knee OA. Participants' decision-making was influenced by (1) symptoms, in particular pain and effect on physical functioning; (2) the opinion of others; (3) a weighing up of risks with benefits and (4) information sources.
  
  
  CONCLUSIONS
  Participants with end-stage knee OA were less willing to undergo surgery than those with hip OA. There is a need to provide more treatment options and quality information and advice to individuals to enable informed decision-making.
authors.affiliation: School of Nursing, Midwifery & Social Work, University of Manchester, University Place, Manchester, UK. gretl.mchugh@manchester.ac.uk
authors.forename: Gretl A
authors.initials: GA
authors.lastname: McHugh
authors.forename: Karen A
authors.initials: KA
authors.lastname: Luker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000523:psychology / Q000601:surgery*; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000601:surgery*; D036301:Qualitative Research; D011788:Quality of Life; D018570:Risk Assessment