Patient participation in orthopaedic care: a survey on hip surgery patients' preferences for and experiences of engagement in their health

Introduction Quality in health services is increasingly associated with enabling patients to participate in their own health and healthcare by recognising their resources and needs. Despite a growing recognition as to whether such participation is enabled, little is known regarding opportunities for preference-based patient participation in orthopaedic care. Aims To investigate preference-based participation for patients in orthopaedic care due to hip surgery.MethodsPatients across 17 Swedish orthopaedic units who had had hip surgery, due to hip fracture or osteoarthritis, January–April 2021 were invited to complete the validated 4Ps questionnaire. Of 1514 patients, 458 patients returned the questionnaire with reports on their preferences for and experiences of participation. Each of the 4Ps’ 12 items were analysed separately using descriptive and comparative statistics. Results A complete match in preferences for, and experiences of, participation was achieved with variation between items for 41%–50% of the patients; if almost matches were included, this occurred for 57%–77% of the patients. Less participation than preferred was most common in terms of having had reciprocal communication, opportunities for partaking in planning, and in learning how to manage symptoms/issues. Hip fracture surgery was significantly associated with experiencing lower levels of participation than preferred. Conclusion Though standardised care promotes efficient hip surgery care, our study suggests a need for more person-centred opportunities to engage. A discrepancy was noted between patients’ resources and preparation for their participation in and beyond the hip surgery process, particularly for self-care activities, calling for better use of nursing resources.