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Published on: October 29, 2021
Perspectives on Communicating Information and Shared Decision-Making in Patients Undergoing Transtibial Amputation
Lina Walther Sjödin1,2, Lasse J Lapidus1,2, Eva Torbjörnsson1,3
1Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
Purpose:
Patients undergoing lower extremity amputation often desire to take an active part in decision-making. The primary aim of this study was to explore patients' experiences of the care trajectory and information provided after a new care program was introduced. The secondary aim was to explore patients' perspectives of their involvement and participation in shared decision-making throughout the care process. The care program features new educational material, recommendations for the sagittal surgical technique, and information about a rigid removable dressing, early liner treatment, and a multidisciplinary team follow up three weeks after amputation.
Methods:
Fifteen participants who underwent transtibial amputation were included in the study and were interviewed two to three months post-surgery. Purposeful sampling was used, and data were analyzed with content analysis.
Results:
Three themes were identified: (1) the emotionally mixed experience of becoming a person with an amputation, (2) the need to be seen during the amputation process, and (3) the importance of being involved in care. Participants wanted to take a more active role in the decision-making process, and our multidisciplinary team follow up was an excellent example of shared decision-making. Printed information was appreciated, but the most crucial aspect was oral communication, given the gravity of the subject. Participants experienced a lack of continuity throughout the care trajectory.
Conclusions:
Individualized oral information and interaction with dedicated healthcare professionals are essential for participants undergoing transtibial amputation. Implementing a multidisciplinary team consultation pre-amputation may enhance patient involvement and promote shared decision-making.
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