Amputation in the perception of those who experience it: a study under the phenomenological

Chini, Gislaine Cristina de Oliveira; Boemer, Magali Roseira

doi:10.1590/s0104-11692007000200021

Cited by 16 publications

(18 citation statements)

References 6 publications

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“…Qualitative research of persons with upper limb loss can provide a meaningful view into the values, perspectives, opinions, and priorities of this community in a way that structured surveys and standardized metrics cannot. Qualitative analysis has been utilized to understand the psychosocial adjustment process to lower limb amputation in diabetics [24], the psychosocial adjustment to traumatic amputation in women [25], the holistic impact of a novel terminal device on upper limb amputees [26], the experience of successful prosthesis users [27], the experience of living with an osseointegrated prosthesis [11], and the experience of living with limb loss [28,29]. However, to our knowledge, the role of sensation in the experience of limb loss has not been investigated using qualitative methods.…”

Section: Introductionmentioning

confidence: 99%

The benefits of sensation on the experience of a hand: A qualitative case series

et al. 2019

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BackgroundThe experience of upper limb loss involves loss of both functional capabilities and the sensory connection of a hand. Research studies to restore sensation to persons with upper limb loss with neural interfaces typically measure outcomes through standardized functional tests or quantitative surveys. However, these types of metrics cannot fully capture the personal experience of living with limb loss or the impact of sensory restoration on this experience. Qualitative studies can demonstrate the viewpoints and priorities of specific persons or groups and reveal the underlying conceptual structure of various aspects of their experiences.Methods and findingsFollowing a home use trial of a neural-connected, sensory-enabled prosthesis, two persons with upper limb loss were interviewed about their experiences using the sensory restoration system in unsupervised, unconstrained settings. We used grounded theory methodology to examine their experiences, perspectives, and opinions about the sensory restoration system. We then developed a model to describe the impact of sensation on the experience of a hand for persons with upper limb loss.ConclusionsThe experience of sensation was complex and included concepts such as the naturalness of the experience, sensation modality, and the usefulness of the sensory information. Sensation was critical for outcome acceptance, and contributed to prosthesis embodiment, confidence, reduced focus and attention for using the prosthesis, and social interactions. Embodiment, confidence, and social interactions were also key determinants of outcome acceptance. This model provides a unified framework to study and understand the impact of sensation on the experience of limb loss and to understand outcome acceptance following upper limb loss more broadly.

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Section: Introductionmentioning

confidence: 99%

The benefits of sensation on the experience of a hand: A qualitative case series

et al. 2019

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“…These results are congruent with our findings of an out of control or creeping decay of the flesh, and relentless pain during the lead‐in (preoperative) period of complex wounds requiring regular analgesia and dressing routines, and repeated attempts to revascularise limbs. Relentless pain and its impact on activities of daily living during the lead‐in to amputation of months to years were echoed in the description of Rassin, Tzevlin, Malul, Harel, and Shakhar () as “a trail of torment.” Several studies (Chini & Boemer, ; Liu, Williams, Liu, & Chien, ; Rassin et al, ; Torbjörnsson, Ottosson, Blomgren, Boström, & Fagerdahl, ) also described the pain of CLTI as involving “suffering” and several reported subsequent problems with sleep (Rassin et al, ; Torbjörnsson et al, ). Mohler and Schnepp () and Rassin et al () addressed the variable length and intensity of health deterioration as amputation approached.…”

Section: Discussionmentioning

confidence: 99%

“…Relentless pain and its impact on activities of daily living during the lead-in to amputation of months to years were echoed in the description of Rassin, Tzevlin, Malul, Harel, and Shakhar (2012) as "a trail of torment." Several studies (Chini & Boemer, 2007;Liu, Williams, Liu, & Chien, 2010;Rassin et al, 2012;Torbjörnsson, Ottosson, Blomgren, Boström, & Fagerdahl, 2017) also described the pain of CLTI as involving "suffering" and several reported subsequent problems with sleep (Rassin et al, 2012;Torbjörnsson et al, 2017). Mohler and Schnepp (2010) and Rassin et al (2012) addressed the variable length and intensity of health deterioration as amputation approached.…”

Section: The Unreliable Bodymentioning

confidence: 99%

The body with chronic limb‐threatening ischaemia: A phenomenologically derived understanding

Monaro

West

Gullick

2020

Journal of Clinical Nursing

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Aims and Objectives To explore person and family lifeworld narratives of chronic limb‐threatening ischaemia (CLTI) after major amputation has been offered as a treatment option. Background Chronic limb‐threatening ischaemia manifests as ischaemic pain, ulceration and/or gangrene and is receiving heightened attention due to the increasing health system burden from associated complex wounds and hospitalisations for repeat procedures. The patient and family impact of these manifestations is not well‐reported: current studies largely seek to measure treatment outcomes. Patient‐reported outcome measurements need to be developed but should be underpinned by rigorous qualitative research. Design Prospective, longitudinal, qualitative design using interpretive phenomenology. Methods The journeys of 19 people with CLTI were explored via 42 semi‐structured interviews with 14 patient and 13 family participants. The initial interview was conducted soon after the advice of the need for major amputation, and where amputation followed, participants were invited for a second interview 6 months postprocedure. Hermeneutic phenomenological analysis was guided by Merleau‐Ponty's philosophy of embodiment. Results People with embodied CTLI faced an existential crisis due to the catastrophic impact of creeping decay of their flesh and vascular system, relentless pain and a sense of spreading poison from gangrene, infection and drugs, which disrupted the interleaving of the physical and existential body. Consequent to the creeping decay and surgery, participants also experienced shifting body boundaries and an unreliable body. Conclusions The lifeworld of the patient and family living with CTLI is irrevocably altered through the disruption of a spontaneous and reliable body. This shapes subsequent therapeutic relationships and discourse. Relevance to Clinical Practice People facing CLTI require early patient‐ and family‐centred discussions about the possibility for major amputation and its potential to arrest the further decline of the body and to support the body's existential expression.

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“…Perder uma parte do corpo pode significar ter a existência alterada, viver um vazio que acarreta uma séria de mudanças na vida da pessoa. Significa ter que adaptar-se e readaptar-se, aprender a viver de novo, aceitar outra perspectiva no mundo 7 . Porém, a amputação também pode gerar sentimentos ambíguos, "ora de tristeza pela perda de parte de seu corpo, ora de alívio da dor e desconfortos provocados pelo odor" 8 .…”

Section: Discussionunclassified

Enfermagem frente à reabilitação de pacientes submetidos à amputação

Mariano¹,

Leal²,

Soares³

2014

revenf

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Resumo: investigar como a enfermagem enfrenta o cuidado ao paciente submetido à amputação de extremidades e quais as ações que contribuempara reabilitação após a alta hospitalar. Método: estudo qualitativo, análise temática. Questões norteadoras: Como a enfermagem enfrenta o cuidadoao paciente com amputação? Os cuidados durante a hospitalização podem contribuir para reabilitação após a alta hospitalar? Coleta com entrevistasgravadas, com 10 profissionais da equipe de enfermagem de uma rede hospitalar pública, Porto Alegre/RS. Porto Alegre/RS. Resultados: na análiseemergiram as duas categorias: características dos pacientes amputados; A equipe de enfermagem frente ao cuidado do paciente amputado. Conclusão: acriação de protocolo sistematizado de atendimento e a revisão do sistema de suporte no pós-alta, pode contribuir para a reabilitação da pessoa amputada.Descritores: Amputação; Enfermagem; Hospitalização; Cuidados de Enfermagem.Nursing facing rehabilitation of patients submitted to amputationAbstract: investigate how nursing care faces the care to the patient with amputation of the extremities and which actions contribute for the re-habilitationafter the hospital discharge. Method: qualitative study and thematic analysis. Guiding questions: How does nursing face the care to the patient withamputation? Can the care given during the hospitalization contribute for the re-habilitation after the hospital discharge? Collection with recordedinterviews, signature of free and cleared up consent statements, in October 2011, with 10 professionals of the nursing staff from a public hospitalnetwork, Porto Alegre-RS. Results: two categories derived from the analysis: Characteristics of the amputated patients; The nursing staff facing the careto the amputated patient. Conclusion: the creation of a systematized attendance protocol and the revision of the support system in the post-dischargecan contribute for the amputated subject re-habilitation.Descriptors: Amputation; Nursing; Hospitalization; Nursing Care.Enfermería ante la rehabilitación de pacientes sometidos a amputaciónResumen: investigar como la enfermería enfrenta el cuidado al paciente sometido a amputación de extremidades y las acciones que contribuyen para larehabilitación tras el alta hospitalaria. Método: estudio cualitativo, análisis temático. Cuestiones orientadoras: ¿Cómo la enfermería enfrenta el cuidadoal paciente con amputación? ¿Pueden los cuidados durante la hospitalización contribuir para la rehabilitación tras el alta hospitalaria? Recolección conentrevistas grabadas, firma de declaraciones de consentimientos libres y esclarecidos, en octubre 2011, con 10 profesionales del equipo de enfermeríade una red hospitalaria pública, Porto Alegre-RS. Resultados: del análisis surgieron dos categorías: Características de los pacientes amputados; El equipode enfermería frente al cuidado del paciente amputado. Conclusión: creación de protocolo sistematizado de atendimiento y la revisión del sistema

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Amputation in the perception of those who experience it: a study under the phenomenological

Cited by 16 publications

References 6 publications

The benefits of sensation on the experience of a hand: A qualitative case series

The benefits of sensation on the experience of a hand: A qualitative case series

The body with chronic limb‐threatening ischaemia: A phenomenologically derived understanding

Enfermagem frente à reabilitação de pacientes submetidos à amputação

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