Patient perspectives on major lower limb amputation – A qualitative systematic review

Schober, Thea-Louise; Abrahamsen, Charlotte

doi:10.1016/j.ijotn.2022.100958

Cited by 16 publications

(11 citation statements)

References 29 publications

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“…In this study, men were more severely affected as 21 out of 47 (44.7%) were in the category of moderate or severe anxiety as compared to 42.8% women. This is contradictory to other surveys, where female dominance regarding mental health conditions was noticed 29,30 .…”

Section: Discussioncontrasting

confidence: 98%

Impact of duration and social support on anxiety amongst amputees

Badar

Malik²,

Rafi³

et al. 2022

ijhs

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Background: Anxiety may be defined as “apprehension, uneasiness or tension that stems from an anticipation of danger, which may be external or internal”. Amputation is “A removal of the limb or its part owing to medical causes/reasons”. Low-level of social support, religiosity & self-efficacy, may have a role in commencement and continuation of mental health condition. Empathy & support are imperative for helping amputees to cope-up with an uncertainty, emotions, mobility issues, and to en-able them to adjust to new normality. Objective: The aim of study was to find an impact of duration and social support on anxiety amongst amputees. Study Design: Cross-sectional study. Place and duration of Study: Physical Rehabilitation Centers of Quetta. Duration of this study was 3 months. Methodology: Primary data was taken from all amputees visiting rehabilitation centers, through structured adopted questionnaire “Hospital Anxiety and Depression Scale” (HADS), with the help of trained data collectors along with principal investigator. Results: 54 subjects were included in this research, of whom. Majority 49 were earning/receiving up to 30000 Pk Rs monthly. Regarding no of dependents, majority (57.5%) had 9 or above no of dependents.

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Section: Discussioncontrasting

confidence: 98%

Impact of duration and social support on anxiety amongst amputees

Badar

Malik²,

Rafi³

et al. 2022

ijhs

View full text Add to dashboard Cite

show abstract

“…Similarly, unforeseen events between the primary MLLA and when an indication for MLLA revision is apparent could mean that some patients with an indication for MLLA revision may no longer be considered appropriate for operative intervention due to lack of fitness for surgery. Additionally, patients’ postoperative experience, emotional changes and quality-of-life vary 46 , 47 , which could influence their decision-making when MLLA revision is offered.…”

Section: Discussionmentioning

confidence: 99%

Long-term risk prediction after major lower limb amputation: 1-year results of the PERCEIVE study

Gwilym,

Pallmann,

Waldron

et al. 2024

BJS Open

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Background Decision-making when considering major lower limb amputation is complex and requires individualized outcome estimation. It is unknown how accurate healthcare professionals or relevant outcome prediction tools are at predicting outcomes at 1-year after major lower limb amputation. Methods An international, multicentre prospective observational study evaluating healthcare professional accuracy in predicting outcomes 1 year after major lower limb amputation and evaluation of relevant outcome prediction tools identified in a systematic search of the literature was undertaken. Observed outcomes at 1 year were compared with: healthcare professionals’ preoperative predictions of death (surgeons and anaesthetists), major lower limb amputation revision (surgeons) and ambulation (surgeons, specialist physiotherapists and vascular nurse practitioners); and probabilities calculated from relevant outcome prediction tools. Results A total of 537 patients and 2244 healthcare professional predictions of outcomes were included. Surgeons and anaesthetists had acceptable discrimination (C-statistic = 0.715), calibration and overall performance (Brier score = 0.200) when predicting 1-year death, but performed worse when predicting major lower limb amputation revision and ambulation (C-statistics = 0.627 and 0.662 respectively). Healthcare professionals overestimated the death and major lower limb amputation revision risks. Consultants outperformed trainees, especially when predicting ambulation. Allied healthcare professionals marginally outperformed surgeons in predicting ambulation. Two outcome prediction tools (C-statistics = 0.755 and 0.717, Brier scores = 0.158 and 0.178) outperformed healthcare professionals’ discrimination, calibration and overall performance in predicting death. Two outcome prediction tools for ambulation (C-statistics = 0.688 and 0.667) marginally outperformed healthcare professionals. Conclusion There is uncertainty in predicting 1-year outcomes following major lower limb amputation. Different professional groups performed comparably in this study. Two outcome prediction tools for death and two for ambulation outperformed healthcare professionals and may support shared decision-making.

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“…Aspects that were particularly problematic included consideration of the relationship between researcher and participants, discussion of ethical issues, and methods for qualitative analysis. To understand how these limitations to reporting identified here compared to qualitative work done in other contexts, we juxtaposed them with some recently published systematic reviews of qualitative evidence ( 23 – 25 ). In general, summary estimates of CASP scores presented within published qualitative evidence syntheses tended to be higher than those calculated for the initiatives within submissions to HTA.…”

Section: Discussionmentioning

confidence: 99%

The Extent and Quality of Qualitative Evidence Included in Health Technology Assessments: A Review of Submissions to Nice and Cadth

Szabo,

Hawkins,

Germeni

2023

Int J Technol Assess Health Care

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Objectives: Qualitative methods allow in-depth exploration of patient experiences and can provide context for healthcare decision making. Frameworks for patient-based evidence in health technology assessment (HTA) are expanding; yet, how extensively qualitative methods are currently used is unclear. This review characterized the extent and quality of qualitative data submitted to National Institute for Health and Care Excellence (NICE) and Canadian Agency for Drugs and Technologies in Health (CADTH) for HTA. Methods: NICE and CADTH submissions from September 2019 to August 2021 were reviewed. Submission characteristics and features of patient-based evidence included within submissions were extracted. The quality of qualitative reporting was assessed using the CASP checklist. Results: Patient-based evidence was included in 83/107 NICE and 119/124 CADTH submissions. A small proportion described qualitative data collection (NICE=14; CADTH=24) and analysis (NICE=6; CADTH=9) methods. One-to-one interviews were the most common data collection method, and thematic analysis was exclusively used. Thirty-three percent of NICE submissions scored >7 yes responses on CASP, versus 78 percent of CADTH submissions. Conclusions: Although patient-based evidence was common in the submissions reviewed, only 14/107 NICE and 24/124 CADTH submissions involved formal qualitative data collection. Use of formal analysis methods was even rarer and reporting tended to be brief. At present, there is little guidance about qualitative evidence most likely to be informative and therefore to potentially impact decision making. Ensuring, however, that qualitative data are collected and analyzed in a systematic, rigorous way will maximize their usefulness and ensure that patient voices are clearly heard. BackgroundIn 2020, an international task force put forth a new consensus definition of health technology assessment (HTA) (1). HTA was defined as a multidisciplinary process using explicit methods to determine the value of a health technology to inform healthcare decision making, with a goal of promoting an equitable, efficient, and high-quality health system (1). Traditionally HTA has focused on the clinical and cost-effectiveness of the health technologies being evaluated (1). However, more recently the use of patient-based evidence in HTA, defined as "knowledge that originates directly from patients about their experiences of health, quality of life, health care, health services, and health research" (2), has been gaining attention. There are many features of patient-based evidence that make it well-suited to contributing to HTA. These types of data can speak to issues like which aspects of treatment value are important to consider from the patient's perspective and help ensure the relevance of the decision outcomes to those who will use the novel interventions under consideration. In addition, the inclusion of patient-based evidence reflects a commitment to partnership with an active role for patients within HTA (2). Patient-based evidence may...

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Patient perspectives on major lower limb amputation – A qualitative systematic review

Cited by 16 publications

References 29 publications

Impact of duration and social support on anxiety amongst amputees

Impact of duration and social support on anxiety amongst amputees

Long-term risk prediction after major lower limb amputation: 1-year results of the PERCEIVE study

The Extent and Quality of Qualitative Evidence Included in Health Technology Assessments: A Review of Submissions to Nice and Cadth

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