Project Details
Abstract
Osteoarthritis (OA) is a degenerative disease commonly affecting older people. For those with
OA who experience joint symptoms that substantially impact their quality of life and are refractory
to non-surgical treatment, joint-replacement surgery should be considered. Many people worldwide
require total joint-replacement surgery due to aging populations and lifestyle patterns contributing
to greater activity and/or overweight. However, waiting lists for total joint replacement are very
long, and support services for OA patients awaiting surgery are limited. Since preoperative
functioning is the strongest determinant of postoperative pain and functioning, it is important to
develop interdisciplinary intervention programs to maintain these patients’ preoperative function. In
Taiwanese clinical settings, family members commonly insist that their older relatives receive
joint-replacement surgery but the older relatives reject surgery, resulting in a tug of war until the
older relative gives up. This phenomenon may be unique to Taiwan; it has not been reported in
Western studies. Thus far, it is unclear why older OA patients reject surgery in Taiwan. Scheduling
knee-replacement surgery at Chang Gung Memorial Hospitals takes 1-3 months. If older OA
patients refuse, it can take a year or more. These older OA patients not only suffer from
illness-related physical, psychological, and social distress, but also experience severe conflicts with
their close family members. These stresses may aggravate older OA patients’ health and quality of
life. No interdisciplinary intervention programs are currently available for older people between
physician-recommended and actual knee joint-replacement surgery in western countries or Taiwan.
However, to design suitable intervention programs, the needs of older people with knee OA and
their family members must first be assessed. It is also important to understand the process of
deciding to undergo joint-replacement surgery. To address these gaps in understanding, we propose
a 3-year study in four stages. In Stage I, we will explore the lived experience of older people with
knee OA, their decision-making process regarding joint-replacement surgery, and their care needs
between recommended and actual knee-replacement surgery. Their family members’ caregiving
experiences, decision-making process, and caregiving needs will also be explored. In Stage II, we
will develop and validate two questionnaires, one to assess care needs of older people with knee
OA between recommended and actual knee-replacement surgery and one to assess caregiving needs
of family members in this period. In Stage III, we will explore the trajectories of physical status,
cognitive function, pain, sleep quality, depressive symptoms, social support, quality of life, and care
needs of older people with knee OA between recommended and actual joint-replacement surgery.
We will also explore their family members’ trajectories of sleep quality, depressive symptoms,
social support, quality of life, and caregiving needs. In Stage IV, we will develop and examine the
feasibility of an interdisciplinary care protocol for older people with knee OA and their family
members between the older person’s recommended and actual joint-replacement surgery. The study
results will provide preliminary suggestions for interdisciplinary intervention protocols for older
people with knee OA and their family members as well as guidelines for developing intervention
programs for this group.
Project IDs
Project ID:PC10401-0764
External Project ID:MOST103-2314-B182-044-MY3
External Project ID:MOST103-2314-B182-044-MY3
Status | Finished |
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Effective start/end date | 01/08/15 → 31/07/16 |
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