Stage of Change: Pre-Contemplation
This patient is in the Pre-Contemplation stage of the Transtheoretical Model of Change. She is unaware of the risks of not having surgery and has not yet begun to consider the full scope of her medical situation, which is the defining characteristic of pre-contemplation 1, 2.
Rationale for Pre-Contemplation Classification
The patient demonstrates the hallmark features of pre-contemplation:
- Lack of awareness of consequences: She is specifically described as "unaware about complications if she will not do the surgery," which is the critical distinguishing feature 1, 2
- Fear without full information: While she expresses fear of surgical complications, this fear exists in isolation without understanding the alternative risks of non-surgical management 1
- Not actively weighing options: She has not progressed to the stage where she is genuinely considering both sides of the decision 3
Why This Is NOT Contemplation
Contemplation stage requires that the patient:
- Acknowledges and understands their diagnosis and its implications - which this patient does not 1
- Actively weighs the pros and cons of both treatment and non-treatment - she only fears one side of the equation 1, 4
- Demonstrates concern about the condition itself - her concern is limited to surgical fear rather than disease progression 1
Research demonstrates that patients in contemplation are "actually thinking about" the decision and have sufficient information to consider both options, whereas pre-contemplators lack this foundational awareness 3.
Clinical Implications
The immediate priority is patient education about the natural history of her knee condition without surgical intervention 5. This includes:
- Risk of progressive disability and reduced quality of life without treatment 5
- Potential for irreversible osteoarthritis if surgical intervention is delayed in appropriate candidates 5
- Comparison of surgical versus non-surgical risks in a balanced, shared decision-making framework 5
Only after providing comprehensive information about both surgical and non-surgical outcomes can this patient progress from pre-contemplation to contemplation 1, 2.