Co-Developing Culturally Responsive Pre-Surgical Education for First Nation and Métis Hip and Knee Replacement Care in Saskatchewan

Background: Arthritis is one of the most common musculoskeletal conditions and a leading cause of disability worldwide. Musculoskeletal conditions affected an estimated 27.8% of Canadians in 2017, with arthritis alone impacting approximately 20% (6 million) of the Canadian population in 2016. Projections suggest this prevalence will increase to 24% (9 million) by 2040, placing a substantial and growing burden on individuals and the healthcare system. Arthritis encompasses over 100 inflammatory conditions, with osteoarthritis (OA) being the most common form, affecting approximately 4 million Canadians. Indigenous Peoples are 1.6 times more likely to have arthritis than non-Indigenous People in Canada yet often face additional barriers to accessing healthcare services. Objective: The purpose of this thesis was to better understand the experiences of First Nation and Métis Peoples in Saskatchewan accessing pre-surgical care for total joint replacements (TJR) and to co-develop a culturally responsive pre-surgical education program in partnership with a patient advisory committee (PAC). Methods: An exploratory qualitative approach was used across two phases of research. In the first phase, semi-structured interviews were conducted with seven First Nation and Métis patients who had undergone or were awaiting hip or knee TJR, and six healthcare providers with experience supporting the TJR process. Patient participants also completed demographic and health questionnaires, with descriptive statistics used to describe participant characteristics. Qualitative data were analyzed using iterative thematic analysis and consensus-building strategies in partnership with two First Nation and Métis patient partners, supported by NVivo 14 software. In the second phase, findings from the first study informed the co-development of a culturally responsive virtual pre-surgical education program for First Nation and Métis Peoples accessing TJR. This phase was conducted in collaboration with physiotherapists at Craven Sport Services (CSS) and a PAC consisting of five First Nation and Métis community members and one non-Indigenous family member. Qualitative data were collected through sharing circles, semi-structured interviews, and field notes, with iterative thematic analysis guiding modifications to an existing osteoarthritis education program presented by CSS. Results: First Nation and Métis patient perspectives highlighted themes related to difficulty accessing care, community and family support, pre-surgical experiences, quality of life, and virtual care. Healthcare provider interviews identified challenges accessing care, education associated with TJR, and future resource and implementation needs. In phase two, findings from PAC perspectives informed revisions to the virtual pre-surgical education program, including the integration of culturally responsive content, lay terminology, and implementation strategies to support relationship-building within a virtual format. Conclusion: Overall, the results from both phases demonstrated a need for increased access to culturally responsive pre-surgical education and rehabilitation services for First Nation and Métis Peoples accessing TJR care. Co-developing virtual education programs in partnership with Indigenous patients may enhance healthcare experiences and improve equitable access to culturally responsive pre-surgical education.

Name thesis:degree_name

Master of Science (M.Sc.)

Level thesis:degree_level

Masters

Discipline thesis:degree_discipline

Health Sciences

Grantor

University of Saskatchewan

Year dc:date.issued

2026

Author dc:creator

• Sawatsky, Rebecca Anne

Advisors dc:contributor.advisor

• Lovo, Stacey
• Bath, Brenna

Committee members dc:contributor.committeemember

• Lovo, Stacey
• Erlandson Feltis, Marta
• Mcllduff, Cari

• Osteoarthritis
• Total Joint Replacement
• pre-surgical
• Indigenous Peoples
• Healthcare Education
• Access to Healthcare
• Rehabilitation
• Physiotherapy

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10388/18794

OAI identifier oai:identifier

oai:harvest.usask.ca:10388/18794