Gender differences in the decision-making process for undergoing total knee replacement
Torrente-Jimenez, Ramon Sebastian (Universitat Autònoma de Barcelona. Departament de Medicina)
Feijoo Cid, Maria (Universitat Autònoma de Barcelona. Departament d'Infermeria)
Rivero-Santana, Amado (Fundación Canaria Instituto de Investigación Sanitaria de Canarias)
Perestelo-Pérez, Lilisbeth (Servicio de Evaluación y Planificación del Servicio Canario de la Salud)
Torres-Castaño, Alezandra (Health Services Research on Chronic Patients Network (REDISSEC))
Ramos-García, Vanesa (Health Services Research on Chronic Patients Network (REDISSEC))
Bilbao, Amaia (Kronikgune Institute for Health Services Research)
Serrano-Aguilar, Pedro (Servicio de Evaluación y Planificación del Servicio Canario de la Salud)

Date:	2022
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.
Grants:	Ministerio de Economía y Competitividad PI15/01264
Note:	Altres ajuts: acords transformatius de la UAB
Note:	This project was supported by Instituto de Salud Carlos III, Ministry of Health, Spain (grant number PI15/01264).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Knee osteoarthritis ; Total knee replacement ; Patient-centered care ; Shared decision-making ; Health disparities
Published in:	Patient Education and Counseling, 2022 , ISSN 1873-5134

DOI: 10.1016/j.pec.2022.08.014
PMID: 36075809

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