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性别差异对肩、髋和膝关节置换术患者观点和体验的影响。

Sex-based Differences in Patient Perspectives and Experiences With Shoulder, Hip, and Knee Arthroplasty.

机构信息

From the San Francisco School of Medicine, University of California, (Dr. Chi, Dr. Fluet, and Mr. Roach), and the San Francisco Department of Orthopedic Surgery, University of California, San Francisco, CA (Dr. Woolley, Dr. Allahabadi, Dr. Ward, and Dr. Wong).

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2024 Apr 19;8(4). doi: 10.5435/JAAOSGlobal-D-24-00083. eCollection 2024 Apr 1.

Abstract

INTRODUCTION

Sex disparities in presentation of osteoarthritis and utilization of joint replacement surgery (JRS) have been demonstrated. The role of patients' unique perspectives on JRS on their treatment decisions is poorly understood.

METHODS

JRS candidates who were offered JRS but declined surgical treatment completed this survey. Survey questions included demographic information, patient experiences and current opinions around JRS, patient experiences with providers, goals and concerns, and barriers to JRS.

RESULTS

More women experience barriers to undergoing JRS compared with men (53% versus 16%; P = 0.014). While both men and women indicated pain relief as their primary goal for treatment, women were significantly more likely to prioritize regaining the ability to complete daily tasks and responsibilities when compared with men (P = 0.007). Both men and women indicated that low symptom severity and nonsurgical treatment options were the reasons for not undergoing JRS (P = 0.455). Compared with men, women trended toward feeling that they were not sufficiently educated about JRS (P = 0.051).

CONCLUSION

Women have unique perspectives and goals for JRS that may pose sex-specific barriers to care. A better understanding of how patients' gendered experiences affect their decision making is necessary to improve treatment of osteoarthritis and decrease disparities in care.

摘要

简介

已经证明,在骨关节炎的表现和关节置换手术(JRS)的利用方面存在性别差异。患者对 JRS 的独特看法对其治疗决策的影响知之甚少。

方法

接受 JRS 但拒绝手术治疗的 JRS 候选者完成了这项调查。调查问题包括人口统计学信息、患者对 JRS 的体验和当前意见、患者与提供者的体验、目标和关注点,以及 JRS 的障碍。

结果

与男性相比,更多的女性在接受 JRS 方面存在障碍(53%比 16%;P = 0.014)。尽管男性和女性都表示缓解疼痛是治疗的主要目标,但与男性相比,女性更有可能将恢复完成日常任务和职责的能力作为首要目标(P = 0.007)。男性和女性都表示症状轻微和非手术治疗选择是不接受 JRS 的原因(P = 0.455)。与男性相比,女性倾向于认为自己对 JRS 的了解不够充分(P = 0.051)。

结论

女性对 JRS 有独特的看法和目标,这可能对她们的护理构成特定性别的障碍。为了改善骨关节炎的治疗并减少护理方面的差异,有必要更好地了解患者的性别体验如何影响他们的决策。

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