Surgery (St Vincent's) - Theses
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ItemThe role of digital technology and gamification to improve health literacy in patients undergoing arthroplasty( 2022)Arthroplasty is a high-volume but costly treatment option for end-stage osteoarthritis. This PhD used a mixed methods approach to explore new strategies to better select and prepare surgical candidates for their surgical journey. A narrative review conveyed how health literacy can improve understanding, rationalise expectations and reduce dissatisfaction in arthroplasty through the medium of digital technology and gamification (the use of gaming elements in a non-gaming context). A quantitative analysis of online arthroplasty information quality demonstrated a marked shortage of reliable resources for patients. A scoping review revealed how existing digital interventions can have a positive impact on related aspects of health literacy, such as knowledge and self-management, despite no structured approach or theoretical framework around these designs. An observational study determined the health literacy profile of a patient cohort undergoing arthroplasty, in whom were lacking the abilities to actively manage their health, and find and appraise health information. It also found that participants who utilised the internet often had higher health literacy, and those able to actively self-manage were three times as likely to progress to surgery. Qualitative research with people before and after their orthopaedic surgery consultation, found those with higher health literacy (including the ability to actively self-manage) had already made the decision to undergo surgery and reflected better surgical candidacy to the surgeon. Finally, interviews with patients about their attitudes, usage and opinions towards a digital tool found that the most effective digital education tool included practical clinical, logistical and lifestyle information, including checklists and timelines, combined with nuanced gamified mechanics, such as points, badges and self-tracking data. The findings from these six studies were synthesized into a concept design for a digital, gamified education tool. It is a data-driven design which ultimately aims to improve health literacy in the context of arthroplasty, empowering patients to obtain evidence-based knowledge, and seek and receive the right treatment at the right time.