First Nation and Métis Needs Assessment for Pre-Surgical Rehabilitation and Education of Hip and Knee Total Joint Replacements in Saskatchewan: Uplifting Indigenous Knowledges.

BACKGROUND: Arthritis impacts approximately one in five Canadians, with hip and knee osteoarthritis being the most prevalent and can require total joint replacement (TJR) surgeries. In Saskatchewan, patients access pre-surgical assessments for hip and knee replacements at urban multidisciplinary clinics, and rural and remote residents face significant barriers to accessing these services. Indigenous Peoples experience disproportionally higher rates of arthritis and additional barriers accessing appropriate care. OBJECTIVES: The objective of this project was to identify the unique needs, strengths, and preferences of First Nation and Métis Peoples in accessing and receiving care for TJR. DESIGN: An explorative qualitative approach. METHODS: This study involved semi-structured qualitative interviews with 7 First Nation and Métis community members who have had or are awaiting hip or knee TJR and 6 orthopedic health care providers who have experience working with First Nation and Métis patients undergoing TJR. Health care providers included men and women, Indigenous and non-Indigenous participants. Community member participants completed a demographic and health questionnaire prior to the interview, with descriptive statistics used to determine participant characteristics. Ages of First Nation and Métis community members ranged from 43 to 75 years old (M = 59.57, SD = 10.66). Iterative thematic analysis and consensus building strategies were used to analyze data using NVivo 14 software. RESULTS: First Nation and Métis patient perspectives highlighted five major themes: 1) Difficulty Accessing Care, 2) Community and Family Support, 3) Pre-Surgical Experience, 4) Quality of Life, and 5) Virtual Care. Health care provider interviews indicated three major themes: 1) Challenges Accessing Care, 2) Education Associated with Total Joint Replacements, and 3) Future Resource and Implementation Needs. CONCLUSION: The results indicated a need for increased access to culturally responsive pre-surgical education and informed recommendations for future pre-surgical rehabilitation care interventions.