Exploring what is important to patients with regards to quality of life after experiencing a lower limb reconstructive procedure: a qualitative evidence synthesis
Open Access
- 31 May 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in Health and Quality of Life Outcomes
- Vol. 19 (1), 1-16
- https://doi.org/10.1186/s12955-021-01795-9
Abstract
Background: Patient reported outcome measures (PROMs) are used to understand the impact of lower limb reconstruction surgery on patients’ quality of life (QOL). Existing measures have not been developed to specifically capture patient experiences amongst adults with lower limb conditions that require reconstruction surgery. This review aimed to synthesise qualitative evidence to identify what is important to patients requiring, undergoing, or following reconstructive surgery for lower limb conditions. Methods: MEDLINE, Embase, PsychINFO and Cinahl were searched from inception until November 2020. Studies were included if they employed qualitative research methods, involved patients requiring, undergoing or following lower limb reconstruction and explored patients’ experiences of care, treatment, recovery and QOL. Mixed methods studies that did not separately report qualitative findings, mixed population studies that were not separately reported and studies in languages other than English were excluded. Included studies were analysed using thematic synthesis. The Critical Appraisal Skills Programme qualitative studies checklist was used to undertake quality assessment. Results: Nine studies met the inclusion criteria. The thematic synthesis identified two overarching themes: (1) areas of living key to QOL for lower limb reconstruction patients and (2) moving towards a new normal. The way in which lower limb reconstruction affects an individual’s QOL and their recovery is complex and is influenced by a range of inter-related factors, which will affect patients to varying degrees depending on their individual circumstances. We identified these factors as: pain, daily functioning and lifestyle, identity, income, emotional wellbeing, support, the ability to adapt and adjust and the ability to move forwards. Conclusions: The way patients’ QOL is affected after a lower limb reconstruction is complex, may change over time and is strongly linked to their recovery. These findings will aid us in developing a conceptual framework which identifies the outcomes important to patients and those that should be included in a PROM. Further research is then required to establish whether the range of factors we identified are captured by existing PROMs. Depending on the outcome of this work, a new PROM for patients following lower limb reconstruction may be required.Keywords
Funding Information
- Hull University Teaching Hospitals NHS Trust
This publication has 44 references indexed in Scilit:
- Enhancing transparency in reporting the synthesis of qualitative research: ENTREQBMC Medical Research Methodology, 2012
- Life impact of ankle fractures: Qualitative analysis of patient and clinician experiencesBMC Musculoskeletal Disorders, 2012
- Beyond PICOQualitative Health Research, 2012
- Content Validity—Establishing and Reporting the Evidence in Newly Developed Patient-Reported Outcomes (PRO) Instruments for Medical Product Evaluation: ISPOR PRO Good Research Practices Task Force Report: Part 1—Eliciting Concepts for a New PRO InstrumentValue in Health, 2011
- A Qualitative Analysis of the Decision-Making Process for Patients with Severe Lower Leg TraumaPlastic and Reconstructive Surgery, 2010
- Methods for the thematic synthesis of qualitative research in systematic reviewsBMC Medical Research Methodology, 2008
- Determinants of Patient Satisfaction After Severe Lower-Extremity InjuriesThe Journal of Bone & Joint Surgery, 2008
- The Patient-Reported Outcomes Measurement Information System (PROMIS)Medical Care, 2007
- A scoring scale for symptom evaluation after ankle fractureArchives of orthopaedic and trauma surgery, 1984
- The Nottingham health profile: Subjective health status and medical consultationsSocial Science & Medicine (1982), 1981