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

Ramon Sebastian Torrente-Jimenez, Maria Feijoo-Cid, Amado Javier Rivero-Santana, Alezandra Torres-Castaño, Vanesa Ramos-García, Amaia Bilbao, Pedro Serrano-Aguilar

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)3459-3465
Number of pages7
JournalPatient Education and Counseling
Volume105
Issue number12
DOIs
Publication statusPublished - Dec 2022

Keywords

  • Health disparities
  • Knee osteoarthritis
  • Patient-centered care
  • Shared decision-making
  • Total knee replacement

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