What factors impact patients' decision to undergo shoulder surgery and subjective feeling of recovery?

The purpose of this study was to both evaluate the influence of specific factors, including sleep, driving, and other activities of daily living, on a patient's decision to undergo shoulder surgery and their feeling of recovery after surgery and identify associations between participant demographics and their priorities in deciding to undergo shoulder surgery or feel recovered following surgery.

An anonymous survey was conducted from May to December 2022 among adults aged 18 and older. Participants ranked the importance of pain, shoulder function, sleep, driving, and self-care in their decision to undergo shoulder surgery and in their perception of recovery. They also estimated the expected time to recovery for each activity. Responses were analyzed using descriptive statistics and multivariate logistic regression.

The cohort consisted of 107 respondents, with 51.4% identifying as male. When asked to rank factors in order of importance for decision to undergo shoulder surgery, shoulder pain (45.8%) was most frequently ranked as the most influential factor, followed by the impaired ability to perform daily self-care activities (20.6%), decreased shoulder function (14%), difficulty driving (10.3%), and difficulty sleeping (9.3%). The most important factor in the feeling of recovery was sleeping on the affected side (73.8%), followed by toileting (67.3%), driving (60.7%), and ability to do usual work (32.1%). Multivariate logistic regression modeling revealed female gender (P = .002), English as first language (P = .036), and Asian (P < .001) and Black (P = .019) races as less likely to consider shoulder surgery. Participants with an income level higher than $100,000 per year (P = .022) are more likely to consider undergoing shoulder surgery. Black race (P = .024) was associated with a higher likelihood of prioritizing pain in surgical decision-making, while being married (P = .003) or having greater confidence in completing medical forms (P = .009) were associated with lower likelihood.

Pain was the primary factor influencing the decision to undergo shoulder surgery, followed by ability to drive. Black and Asian race, female sex, lower income, and English as a first language were linked to lower likelihood of pursuing surgery, while prioritizing driving increased likelihood. Among those who felt recovered, pain relief was most important, followed by self-care, function, sleep, and driving. Black participants placed greater emphasis on pain, married participants less so. Understanding these priorities can help guide goal-setting in surgical discussions.