Decision-making experience of elderly patients for joint replacement surgery in China: a qualitative study

To gain an in-depth understanding of the experience of elderly joint replacement patients in making surgical decisions and to identify the needs of patients in the decision-making process.

A qualitative study, semistructured interviews were used and analysed by Colaizzi's seven-step method.

This study was conducted in the orthopaedics department of a tertiary hospital in Wuhan.

Eligible participants were aged 60 years or older, scheduled for elective joint replacement surgery, cognitively intact and voluntarily consented to participate in the study.

We conducted interviews with a total of 25 elderly patients who underwent joint replacement surgery. This study reveals three themes and eight subthemes regarding the surgical decision-making experiences of elderly patients undergoing joint replacement. The three themes summarise three stages of the decision-making experience, respectively, trade-offs before decisions, feelings during decision-making and expectations after the decision. In the first stage, three subthemes were identified: (1) weighing the surgical risks and benefits, (2) assessment of medical proficiency and (3) low patient involvement in decision-making. In the second stage, three subthemes emerged: (1) internal fear, (2) self-doubt and (3) a heavy burden. In the third stage, two subthemes were identified: (1) a recovery process filled with confidence and (2) a desire for improved quality of life.

This study delves deep into the experiences of elderly patients undergoing joint replacement surgery during the surgical decision-making process. It provides a theoretical basis for decision-making assistance for elderly joint replacement patients, which is conducive to reducing patients' decision-making conflicts and enhancing their decision-making capabilities.