Kate Sansam1, Rory J O'Connor, Vera Neumann, Bipin Bhakta. 1. Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Level D, Martin Wing, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, United Kingdom. katesansam@hotmail.com.
Abstract
OBJECTIVE: Decision making within amputee rehabilitation includes the assessment of whether a patient is suitable for a prosthesis and if so, what components to provide. This study seeks to increase understanding about clinicians' perspectives on what factors influence these decisions. METHOD: One-to-one semi-structured interviews were completed with 23 experienced clinicians at their place of work at 4 UK amputee rehabilitation centres. Thematic analysis using a theoretical, semantic approach was used to identify key themes from the data. RESULTS: Four key themes were identified: estimating outcome; difficulties predicting outcome; patient choice and barriers to prescribing. There was variation in the importance placed on each theme between individual clinicians and services, with factors such as budget and risk aversion acting as barriers to prescribing. Only one of the 4 centres used formal prescribing guidelines. CONCLUSION: The results highlight the difficulties clinicians experience in estimating outcome and suggest inequity of prosthetic provision in the UK, with variation in the provision of high cost items. The development of national prescription guidelines is suggested to improve equality of prosthetic provision.
OBJECTIVE: Decision making within amputee rehabilitation includes the assessment of whether a patient is suitable for a prosthesis and if so, what components to provide. This study seeks to increase understanding about clinicians' perspectives on what factors influence these decisions. METHOD: One-to-one semi-structured interviews were completed with 23 experienced clinicians at their place of work at 4 UK amputee rehabilitation centres. Thematic analysis using a theoretical, semantic approach was used to identify key themes from the data. RESULTS: Four key themes were identified: estimating outcome; difficulties predicting outcome; patient choice and barriers to prescribing. There was variation in the importance placed on each theme between individual clinicians and services, with factors such as budget and risk aversion acting as barriers to prescribing. Only one of the 4 centres used formal prescribing guidelines. CONCLUSION: The results highlight the difficulties clinicians experience in estimating outcome and suggest inequity of prosthetic provision in the UK, with variation in the provision of high cost items. The development of national prescription guidelines is suggested to improve equality of prosthetic provision.
Authors: Chelsey B Anderson; Andrew J Kittelson; Shane R Wurdeman; Matthew J Miller; Jason W Stoneback; Cory L Christiansen; Dawn M Magnusson Journal: Disabil Rehabil Date: 2022-04-07 Impact factor: 2.439
Authors: Jaclyn Megan Sions; Emma Haldane Beisheim; Tara Jo Manal; Sarah Carolyn Smith; John Robert Horne; Frank Bernard Sarlo Journal: Arch Phys Med Rehabil Date: 2018-02-01 Impact factor: 3.966