Chelsea Leonard1, George Sayre2,3,4,5, Sienna Williams2,6, Alison Henderson2, Daniel Norvell2,6,7, Aaron P Turner2, Joseph Czerniecki2,6,7. 1. Denver Seattle COIN. VA Eastern Colorado Healthcare System, Aurora, Colorado, United States of America. 2. VA Puget Sound Health Care System, Seattle, Washington, United States of America. 3. Qualitative Research Core, HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington, United States of America. 4. VA Collaborative Evaluation Center (VACE), Seattle, Washington, United States of America. 5. Department of Health Services, University of Washington, Seattle, Washington, United States of America. 6. VA Center for Limb Loss and Mobility (CLiMB), Seattle, Washington, United States of America. 7. Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America.
Abstract
PURPOSE: There is limited qualitative research on the experience of patients undergoing lower limb amputation due to chronic limb threatening ischemia (CLTI) and their participation in amputation-level decisions. This study was performed to understand patient lived experiences related to amputation and patient involvement in shared decision making. MATERIALS AND METHODS: Phenomenological interviews were conducted with Veterans 6-12 months post transtibial or transmetatarsal amputation due to CLTI. Interviews were read and summarized by two analysts who discussed the contents of each interview and relationships between interviews to identify emergent, cross-cutting elements of patient experience. RESULTS: Twelve patients were interviewed between March and August 2019. Three cross cutting elements of patient lived experience and participation in shared decision making were identified: 1) Lacking a sense of decision making; 2) Actively working towards recovery as response to a perceived loss of independence; and 3) Experiencing amputation as a Veteran. CONCLUSIONS: Patients did not report a high level of involvement in shared decision making about their amputation or amputation level. Understanding patient experiences and priorities is crucial to supporting shared decision making for Veterans with amputation due to CLTI.
PURPOSE: There is limited qualitative research on the experience of patients undergoing lower limb amputation due to chronic limb threatening ischemia (CLTI) and their participation in amputation-level decisions. This study was performed to understand patient lived experiences related to amputation and patient involvement in shared decision making. MATERIALS AND METHODS: Phenomenological interviews were conducted with Veterans 6-12 months post transtibial or transmetatarsal amputation due to CLTI. Interviews were read and summarized by two analysts who discussed the contents of each interview and relationships between interviews to identify emergent, cross-cutting elements of patient experience. RESULTS: Twelve patients were interviewed between March and August 2019. Three cross cutting elements of patient lived experience and participation in shared decision making were identified: 1) Lacking a sense of decision making; 2) Actively working towards recovery as response to a perceived loss of independence; and 3) Experiencing amputation as a Veteran. CONCLUSIONS: Patients did not report a high level of involvement in shared decision making about their amputation or amputation level. Understanding patient experiences and priorities is crucial to supporting shared decision making for Veterans with amputation due to CLTI.
Authors: J M Czerniecki; M L Thompson; A J Littman; E J Boyko; G J Landry; W G Henderson; A P Turner; C Maynard; K P Moore; D C Norvell Journal: Br J Surg Date: 2019-05-28 Impact factor: 6.939
Authors: J Feinglass; W H Pearce; G J Martin; J Gibbs; D Cowper; M Sorensen; W G Henderson; J Daley; S Khuri Journal: Surgery Date: 2001-07 Impact factor: 3.982
Authors: Robert E Burke; Chelsea Leonard; Marcie Lee; Roman Ayele; Ethan Cumbler; Rebecca Allyn; S Ryan Greysen Journal: J Hosp Med Date: 2019-08-16 Impact factor: 2.960
Authors: Joseph M Czerniecki; Aaron P Turner; Rhonda M Williams; Mary Lou Thompson; Greg Landry; Kevin Hakimi; Rebecca Speckman; Daniel C Norvell Journal: J Vasc Surg Date: 2016-10-14 Impact factor: 4.268
Authors: Catherine H Yu; Dawn Stacey; Joanna Sale; Susan Hall; David M Kaplan; Noah Ivers; Jeremy Rezmovitz; Fok-Han Leung; Baiju R Shah; Sharon E Straus Journal: Implement Sci Date: 2014-01-22 Impact factor: 7.327