Hawker Gillian A
Division of Rheumatology, Department of Medicine, Women's College Hospital, University of Toronto, 76 Grenville Street, Toronto, Ontario, Canada.
Curr Opin Rheumatol. 2006 Sep;18(5):526-30. doi: 10.1097/01.bor.0000240367.62583.51.
Although total joint replacement is an effective treatment for advanced arthritis, many whom might benefit are unwilling to consider this procedure. This review highlights advances in understanding of patients' perceptions of total joint replacement.
Research shows that patients' willingness to consider total joint replacement varies by sex, race/ethnicity, and socioeconomic status as a result of systematic differences in knowledge and beliefs about the procedure. Individuals with low socioeconomic status and minorities view the procedure less favorably than their wealthier, white counterparts, possibly partly explaining disparity in rates of use of the procedure among these groups. Among those undergoing total joint replacement, up to 30% experience a suboptimal outcome or are dissatisfied with results. Early work suggests that patients' expectations and self-efficacy are important potential predictors of postoperative outcome. Patient information needs regarding total joint replacement vary significantly and possibly systematically by sex and race/ethnicity. Available information materials may not address the concerns of many individuals contemplating the procedure, posing a potential barrier to surgery.
Targeted culturally sensitive knowledge dissemination strategies are needed to improve the knowledge and beliefs of people with hip/knee arthritis about total joint replacement.
尽管全关节置换术是治疗晚期关节炎的有效方法，但许多可能受益的人却不愿考虑这一手术。本综述重点介绍了在理解患者对全关节置换术看法方面取得的进展。
研究表明，由于对该手术的知识和信念存在系统性差异，患者考虑全关节置换术的意愿因性别、种族/民族和社会经济地位而异。社会经济地位较低的个体和少数族裔对该手术的看法不如富裕的白人，这可能部分解释了这些群体在手术使用率上的差异。在接受全关节置换术的患者中，高达30%的人预后不理想或对结果不满意。早期研究表明，患者的期望和自我效能是术后结果的重要潜在预测因素。患者关于全关节置换术的信息需求因性别和种族/民族而有显著差异，甚至可能存在系统性差异。现有的信息材料可能无法解决许多考虑该手术的人的担忧，这对手术构成了潜在障碍。
需要有针对性的、对文化敏感的知识传播策略，以提高髋/膝关节炎患者对全关节置换术的知识和信念。
