A Qualitative Study of Factors Influencing the Decision to Have an Elective Amputation

Quon, Deanna; Dudek, Nancy; Marks, Meridith; Boutet, Mish; Varpio, Lara

doi:10.2106/jbjs.j.01998

Cited by 25 publications

(13 citation statements)

References 20 publications

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“…First, we have a relatively small sample of patients though it is within the range of other studies investigating similar topics. 16 Second, our sample is relatively educated and included no minority patients. Therefore, the generalizability to all patients may be limited.…”

Section: Discussionmentioning

confidence: 99%

Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing

Kandrack

Mehrotra

DeVries

et al. 2015

Health Services Research and Managerial Epidemiology

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Health plans are encouraging consumerism among joint replacement patients by reporting information on hospital costs and quality. Little is known about how the proliferation of such initiatives impacts patients’ selection of a surgeon and hospital. We performed a qualitative analysis of semistructured interviews with 13 patients who recently received a hip or knee replacement surgery. Patients focused on the choice of a surgeon as opposed to a hospital, and the surgeon choice was primarily made based on reputation. Most patients had long-standing relationships with an orthopedic surgeon and tended to stay with that surgeon for their replacement. Despite growing availability of cost and quality information, patients almost never used such information to make a decision.

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Section: Discussionmentioning

confidence: 99%

Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing

Kandrack

Mehrotra

DeVries

et al. 2015

Health Services Research and Managerial Epidemiology

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“…In response to the limitations of quantitative approaches to these and other topic areas, health and disability researchers have begun to use qualitative research methods to identify what the meanings of ill health and disability are from the point of view of those concerned. With particular regard to the topics of amputation and prosthesis use, qualitative research has been useful in deepening an understanding of a number of complex areas including factors influencing the decision to have an elective amputation [9], the experiences of prosthetic prescription by lower limb prosthetic users [10], the management of amputation-related pain [11], and communication difficulties with prosthetists [12].…”

Section: Review Articlementioning

confidence: 99%

The experience of amputation and prosthesis use for adults: a metasynthesis

Murray

Forshaw

2012

Disability and Rehabilitation

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The findings provide a base from which to make suggestions regarding the provision of health rehabilitation services for this population. It is recommended that such services make greater use of psychological interventions and education, include patients' social support networks, use psychotherapy to support and develop positive coping strategies, and facilitate peer support from those who have already made positive adjustments to amputation and prosthesis use.

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“…Previous studies have shown that the collaborative process of medical decision-making between patients and their physicians is influenced by a variety of factors, such as individual patient and family experiences, and the opinions of family, friends, or other knowledgeable parties. 10,11 For elective reconstructive procedures aimed solely at improving quality of life (rather than increasing life expectancy), the concept of risk-benefit is often more individualized and varied according to patient specific desires and values. 11,12 Thus, among these interventions, it is imperative to understand the motivations, preferences, and expectations that drive medical decision-making in order to maximize the likelihood of patient satisfaction and improved outcomes.…”

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confidence: 99%

Medical Decision-Making among Adolescents with Neonatal Brachial Plexus Palsy and Their Families

Squitieri

Larson

Chang

et al. 2013

Plastic &Amp; Reconstructive Surgery

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Background Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with NBPP and their families faced with making complex treatment decisions. The experiences of these patients and their parents were analyzed to identify key factors in the decision-making process. Patients and Methods Eighteen adolescents with residual NBPP deficits between the ages of 10 to 17 years along with their parents were included in the present study. A qualitative research design was employed involving the use of separate one hour, in person, semi-structured interviews, which were audio recorded and transcribed. Grounded theory was applied by two independent members of the research team to identify recurrent themes and ultimately create a codebook that was then applied to the data. Results Medical decision-making among adolescents with NBPP and their families is multifaceted and individualized, comprised of both patient and system dependent factors. Four codes pertaining to the medical decision-making process were identified: 1) knowledge acquisition, 2) multidisciplinary care, 3) adolescent autonomy, and 4) patient expectations and treatment desires. Overall, parental decision-making was heavily influenced by system dependent factors, while adolescents largely based their medical decision-making on individual treatment desires to improve function and/or aesthetics. Conclusions There are many areas for improving the delivery of information and health care organization among adolescents with NBPP and their families. We recommend the development of educational interdisciplinary programs and decision aids containing evidence-based management guidelines targeted toward primary care providers and patients. We believe that a computer-based learning module may provide the best avenue to achieve maximum penetrance and convenience of information sharing.

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A Qualitative Study of Factors Influencing the Decision to Have an Elective Amputation

Cited by 25 publications

References 20 publications

Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing

Patient Use of Cost and Quality Data When Choosing a Joint Replacement Provider in the Context of Reference Pricing

The experience of amputation and prosthesis use for adults: a metasynthesis

Medical Decision-Making among Adolescents with Neonatal Brachial Plexus Palsy and Their Families

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