Dissertation
"No one just decides to have their pelvis broken for fun": a qualitative exploration of periacetabular osteotomy surgical decision-making by adult patients with hip dysplasia
Doctor of Health Science (D.H.Sc.), Drexel University
Jun 2023
DOI:
https://doi.org/10.17918/00001677
Abstract
Background: Periacetabular osteotomy (PAO) surgery presents an opportunity for shared decision-making (SDM), and may be facilitated by decision-making tools and resources. Little is known about PAO surgery decision-making in adult patients with hip dysplasia. This key stakeholder perspective is needed to inform decision-making tool and resource development. Questions/Purposes: This qualitative study aimed to gain knowledge about the nature and experience of adult patients with hip dysplasia who had PAO surgery. Specific research questions addressed: 1) Patient information and decision-support needs, (2) Factors that were important to patients who had surgery, (3) Patients' experiences with the surgical decision-making process, and (4) Elements of SDM patients experienced during PAO surgery decision-making. Methods: Fifteen volunteer participants were recruited through hip dysplasia online support groups using a purposive, maximum variation sampling strategy. Participants responded to survey questions and participated in video-based, semi-structured interviews. Qualitative data were analyzed using principles of reflexive thematic analysis. Semantic and inductive approaches to data analysis were used, with coding and theme development approached from experiential and essentialist positions. Results: Three primary themes were developed. Theme 1, Life Disrupted, describes the significant biopsychosocial impacts of hip dysplasia symptoms, diagnosis, and PAO surgery decision-making. Theme 2, It's More Than a Raised Toilet Seat, describes complex and individualized patient information needs, and Theme 3, Meet Me Where I'm At, describes patient-centered care needs around surgery decision-making processes and roles. Decision-making was facilitated when: 1) PAO surgery indications and goals aligned with patients' personal preferences, values, and goals for surgery; 2) complex, individualized decision-making information needs were met; and 3) actual decision-making processes and roles aligned with patients' preferred roles and processes. The degree to which these facilitators were achieved impacted patients' decision-making experiences. Conclusions: This qualitative study validates the challenges and complexities of PAO surgery decision-making and supports the need for SDM. This work illustrates how the SDM steps of provider-to-patient and patient-to-provider information exchange can achieve key facilitators for patient decision-making. The patient stakeholder perspectives gained through this study should be considered during PAO surgery decision-making tool and resource development to promote consistent and effective SDM for PAO surgery decisions.
Metrics
421 File views/ downloads
40 Record Views
Details
- Title
- "No one just decides to have their pelvis broken for fun"
- Creators
- Nancy B. Muir
- Contributors
- Margo N. Orlin (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Health Science (D.H.Sc.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xii, 90 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991020876809404721