Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how should participate decisions. Evaluating the feasibility and desirability carrying out decision-making requires understanding preoperative conversations. The objective this qualitative study was characterize consultations for primary knee arthroplasty arrived at anesthesia. Methods This focused ethnography performed a U.S. academic medical center. authors audio-recorded 36 with eight anesthesiologists. Patients anesthesiologists also participated semi-structured interviews. Consultation interview transcripts were coded an iterative process develop explanation made Results found variation across accounts as whether collaborative scenario or simply meant inform patients. Consultations displayed number patterns, from anesthesiologist not disclosing options strictly adhering position equipoise; however, most fell between these poles, presenting options, recommending one, persuading hesitant accept it. Anesthesiologists feel more comfortable their proposed approach extensive comparisons familiar experiences. Conclusions Anesthesia are multifaceted encounters that serve functions. In some cases, involvement determining anesthetic might be important Broad consideration given both applicability consultation. potential benefits interventions designed enhance patient weighed against pull anesthesiologists’ attention away humanistic aspects communication such decreasing patients’ anxiety. Editor’s Perspective What We Already Know Topic Article Tells Us That Is New