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

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  • Toye, Francine M.
  • Barlow, Julie
  • Wright, Chris
  • Lamb, Sarah E.

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.

Suggested Citation

  • Toye, Francine M. & Barlow, Julie & Wright, Chris & Lamb, Sarah E., 2006. "Personal meanings in the construction of need for total knee replacement surgery," Social Science & Medicine, Elsevier, vol. 63(1), pages 43-53, July.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:1:p:43-53
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    References listed on IDEAS

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    1. Orbell, Sheina & Johnston, Marie & Rowley, David & Espley, Arthur & Davey, Peter, 1998. "Cognitive representations of illness and functional and affective adjustment following surgery for osteoarthritis," Social Science & Medicine, Elsevier, vol. 47(1), pages 93-102, July.
    2. Joanna Sale & Lynne Lohfeld & Kevin Brazil, 2002. "Revisiting the Quantitative-Qualitative Debate: Implications for Mixed-Methods Research," Quality & Quantity: International Journal of Methodology, Springer, vol. 36(1), pages 43-53, February.
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    Cited by:

    1. Susanne Hoffmann & Francis G. Caro & Alison S. Gottlieb & Iris Kesternich & Joachim K. Winter, 2014. "Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery," Medical Decision Making, , vol. 34(5), pages 603-614, July.
    2. Hsiu‐Hui Su & Yun‐Fang Tsai & Wen‐Jen Chen & Min‐Chi Chen, 2010. "Health care needs of patients during early recovery after total knee‐replacement surgery," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(5‐6), pages 673-681, March.

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