title: Factors related to the indecision of older adults with knee osteoarthritis about receiving physician-recommended total knee arthroplasty.
abstract: To explore factors related to the indecision of older adults with knee osteoarthritis (OA) about receiving physician-recommended total knee arthroplasty (TKA) and their needs during the decision-making process.
  
  
  
  Older outpatients with knee OA and undecided about physician-recommended TKA (N = 26) were recruited by convenience from two medical centers and one regional hospital in northern Taiwan. Data were collected in individual interviews using a semi-structured guide and analyzed by thematic analysis.
  
  
  
  Participants' indecision about receiving physician-recommended TKA was due to four major concerns: treatment-related concerns, physical condition-related concerns, surgery-related concerns, and postsurgical care concerns. The few participants (n = 6) who expressed needs during the decision-making process wanted more information about preparing for surgery, postsurgical care, rehabilitation, and medicines.
  
  
  
  Healthcare providers are challenged to respect the decision-making process of older adults with OA regarding recommended TKA while maintaining their quality of life. These adults need appropriate information not only about the relationship between OA suffering and quality of life, but also TKA. While these patients are deciding whether to undergo physician-recommended TKA, they also need information about preparations for surgery, postsurgical care, rehabilitation, and medicines. Implications for Rehabilitation Total knee arthroplasty (TKA) can significantly relieve pain and improve function for older adults with knee osteoarthritis (OA), but many are unwilling to receive the surgery. Our older adult participants with knee OA ascribed their indecision about receiving physician-recommended TKA to treatment-related, physical condition-related, surgery-related, and postsurgical care-related concerns. Healthcare providers need to provide appropriate information to older adults with knee OA not only about the relationship between OA suffering and quality of life, but also about TKA. Healthcare providers should also provide these patients information about preparing for surgery, postsurgical care, rehabilitation, and medicines while they are deciding whether to undergo TKA.
authors.affiliation: a Department of Orthopedic Surgery , Chang Gung Memorial Hospital , Tao-Yuan , Taiwan.|b Bone and Joint Research Center, Chang Gung Memorial Hospital , Tao-Yuan , Taiwan.|c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Wen-Ling
authors.initials: WL
authors.lastname: Yeh
authors.affiliation: d School of Nursing , College of Medicine, Chang Gung University , Tao-Yuan , Taiwan.|e Department of Nursing , Chang Gung University of Science and Technology , Tao-Yuan , Taiwan.|f Department of Psychiatry , Chang Gung Memorial Hospital , Keelung , Taiwan.
authors.forename: Yun-Fang
authors.initials: YF
authors.lastname: Tsai
authors.affiliation: a Department of Orthopedic Surgery , Chang Gung Memorial Hospital , Tao-Yuan , Taiwan.|c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Kuo-Yao
authors.initials: KY
authors.lastname: Hsu
authors.affiliation: c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.|g Department of Orthopedic Surgery , Chang Gung Memorial Hospital , Keelung , Taiwan.
authors.forename: Dave Weichih
authors.initials: DW
authors.lastname: Chen
authors.affiliation: c College of Medicine , Chang Gung University , Tao-Yuan , Taiwan.|f Department of Psychiatry , Chang Gung Memorial Hospital , Keelung , Taiwan.
authors.forename: Ching-Yen
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D003657:Decision Making; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010353:Patient Education as Topic; D011788:Quality of Life; D012494:Sampling Studies; D013624:Taiwan
keywords: Osteoarthritis; decision making; needs; older adults; total knee arthroplasty