Gender differences in the decision-making process for undergoing total knee replacement

Objective: To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). Methods: A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making...

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Detalles Bibliográficos
Autores: Torrente-Jimenez, Ramon Sebastian|||0000-0001-5587-8492, Feijoo Cid, Maria|||0000-0002-7010-373X, Rivero-Santana, Amado|||0000-0002-5067-3196, Perestelo-Pérez, Lilisbeth|||0000-0002-6113-7313, Torres-Castaño, Alezandra|||0000-0003-4690-1421, Ramos-García, Vanesa|||0000-0002-9106-2420, Bilbao, Amaia, Serrano-Aguilar, Pedro|||0000-0002-5373-410X
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:265288
Acceso en línea:https://ddd.uab.cat/record/265288
https://dx.doi.org/urn:doi:10.1016/j.pec.2022.08.014
Access Level:acceso abierto
Palabra clave:Knee osteoarthritis
Total knee replacement
Patient-centered care
Shared decision-making
Health disparities
Descripción
Sumario:Objective: To assess gender differences in the decision-making process for treatment of knee osteoarthritis (OA). Methods: A secondary analysis of a randomized trial was conducted (n = 193). Knowledge of OA and total knee replacement (TKR), decisional conflict, satisfaction with the decision-making process, treatment preference and TKR uptake 6 months later were compared by gender. Multivariate regression models were developed to identify gender-specific predictors. Results: Women showed less knowledge (MD = -7.68, 95% CI: -13.9, -1.46, p = 0.016), reported less satisfaction (MD = -6.95, 95% CI: -11.7, -2.23, p = 0.004) and gave more importance to avoiding surgery (U = 2.09, p = 0.019). In women, more importance attributed to the time needed to relieve symptoms significantly reduced the odds of surgery (OR = 0.76, p = 0.016). Conclusion: The provision of information and/or promotion of shared decision-making could be of lower quality in female patients, although other explanations such as differences in information needs or preference for involvement in decision-making cannot be ruled out with the current evidence. Given the study's limitations, especially regarding the sample size, further confirmation is needed. Practice implications: A systematic, shared decision-making approach in consultation is needed to avoid potential gender-based biases.

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