Sarah Joy Aitken1, Oh Sung Choy2, Sue Monaro3. 1. Department of Vascular Surgery, Concord Repatriation General Hospital, Concord West, NSW, Australia; The University of Sydney, Concord Clinical School, Concord West, NSW, Australia; Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord West, NSW, Australia. Electronic address: sarah.aitken@sydney.edu.au. 2. Department of Vascular Surgery, Concord Repatriation General Hospital, Concord West, NSW, Australia; The University of Sydney, Concord Clinical School, Concord West, NSW, Australia. 3. Department of Vascular Surgery, Concord Repatriation General Hospital, Concord West, NSW, Australia; The University of Sydney, Concord Clinical School, Concord West, NSW, Australia; Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord West, NSW, Australia.
Abstract
BACKGROUND: Chronic limb-threatening ischemia (CLTI) is the debilitating end stage of peripheral artery disease, causing patients to experience low quality of life and poor health outcomes. It is unknown which aspects of care patients with CLTI value. This pilot qualitative study aims to explore patients' concerns and values related to CLTI treatment, to better inform patient-centered care. METHODS: A qualitative study design was piloted to explore the experiences of patients with CLTI undergoing elective vascular surgery. In-depth, semistructured interviews were recorded preoperatively and 3 mo after discharge. Transcribed interviews were analyzed using content analysis, to derive patient-centered themes. Findings were mapped to a framework of patient-centered care. RESULTS: Twelve interviews from six participants were analyzed. Five themes related to participant experiences of CLTI were identified: treatment and diagnosis, concerns about symptoms, limitations in physical function, social function, and emotional function. Participants expressed how CLTI intruded on all aspects of their lives. Framework analysis demonstrated CLTI patients valued patient-centered care relating to both relational and functional aspects of care. In particular, participants valued supportive and trustworthy care, in addition to integrated, holistic care that recognized the patient in the context of their overall health and life. CONCLUSIONS: Feasibility was demonstrated for both study design and methodology. Data obtained from interviews were sufficiently "rich and thick" in quality and quantity to allow for common themes related to experience and health care values in patients with CLTI to be identified. If confirmed in future studies, these findings will enhance patient-centered care in CLTI.
BACKGROUND: Chronic limb-threatening ischemia (CLTI) is the debilitating end stage of peripheral artery disease, causing patients to experience low quality of life and poor health outcomes. It is unknown which aspects of care patients with CLTI value. This pilot qualitative study aims to explore patients' concerns and values related to CLTI treatment, to better inform patient-centered care. METHODS: A qualitative study design was piloted to explore the experiences of patients with CLTI undergoing elective vascular surgery. In-depth, semistructured interviews were recorded preoperatively and 3 mo after discharge. Transcribed interviews were analyzed using content analysis, to derive patient-centered themes. Findings were mapped to a framework of patient-centered care. RESULTS: Twelve interviews from six participants were analyzed. Five themes related to participant experiences of CLTI were identified: treatment and diagnosis, concerns about symptoms, limitations in physical function, social function, and emotional function. Participants expressed how CLTI intruded on all aspects of their lives. Framework analysis demonstrated CLTIpatients valued patient-centered care relating to both relational and functional aspects of care. In particular, participants valued supportive and trustworthy care, in addition to integrated, holistic care that recognized the patient in the context of their overall health and life. CONCLUSIONS: Feasibility was demonstrated for both study design and methodology. Data obtained from interviews were sufficiently "rich and thick" in quality and quantity to allow for common themes related to experience and health care values in patients with CLTI to be identified. If confirmed in future studies, these findings will enhance patient-centered care in CLTI.
Authors: Philip Goodney; Samir Shah; Yiyuan David Hu; Bjoern Suckow; Scott Kinlay; David G Armstrong; Patrick Geraghty; Megan Patterson; Matthew Menard; Manesh R Patel; Michael S Conte Journal: J Vasc Surg Date: 2022-01-24 Impact factor: 4.860