Factors Influencing Decision-Making and Rehabilitation Among Older Women Who Underwent Total Knee Replacement: A Qualitative Study in Taiwan

Ching Han Huang,1 Yun Yee Chen,2 Shu Wen Chen,3 Chen Ti Wang,4 Mei Hsiang Lin3 1Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; 2Department of Rehabilitation Medicine, Taipei City Hospital, Taipei, Taiwan; 3School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; 4Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, TaiwanCorrespondence: Shu Wen Chen, National Taipei University of Nursing and Health Sciences, School of Nursing, No. 365, Ming-Te Road, Peitou District, Taipei, 11219, Taiwan, Email shuwen@ntunhs.edu.tw Yun Yee Chen, Department of Rehabilitation Medicine, Renai Branch, Taipei City Hospital, No. 10, 4 Section 10, Ren-Ai Road, Daan District, Taipei, 10629, Taiwan, Email DAA39@tpech.gov.twPurpose: To explore the factors influencing decision-making and the rehabilitation experiences of older women who underwent total knee replacement (TKR).Methods: A qualitative descriptive design with purposive sampling was employed. Women aged over 60 who had undergone TKR at a medical center in northern Taiwan were recruited during COVID-19 pandemic. Data were collected through two rounds of face-to-face interviews (3– 5 days and 6– 8 weeks post-surgery) and a follow-up telephone interview conducted 6 months after surgery. Thematic analysis was performed using a constant comparative approach.Results: Twenty women participated. A central theme—reclaiming independent life through surgical transformation—emerged, encompassing two interrelated themes: (1) Decision-making factors were driven by pain, external concerns (becoming a burden on the family, body image change), dissatisfaction with conservative treatments, and the influence of significant others (physicians, families and friends, peers); (2) Surgical recovery involved striving to achieve the “rehabilitation golden phase†by enduring pain, establishing personal goals, and working toward functional recovery, while managing “challenges in home-based ...