Patient perspectives of quality of life in chronic limb-threatening ischemia: a qualitative study.

chronic limb-threatening ischemia instrument development qualitative quality of life reflexive thematic analysis

Journal

ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634

Informations de publication

Date de publication:
Mar 2024
Historique:
revised: 11 11 2023
received: 03 09 2023
accepted: 14 11 2023
pubmed: 28 11 2023
medline: 28 11 2023
entrez: 27 11 2023
Statut: ppublish

Résumé

Quality of life (QOL) is an outcome that matters to patients with chronic limb-threatening ischemia (CLTI). However, we identified the lack of and need for a CLTI-specific QOL instrument. Our group is developing this instrument which requires a deep understanding of patient perspectives of QOL in CLTI. Qualitative inquiry with patient and public involvement was performed in accordance with the Standards for Reporting Qualitative Research. Reflexive thematic analysis of semi-structured interviews was conducted within a constructivist-interpretivist research paradigm. Data were organized and managed in NVivo. Techniques to enhance trustworthiness included maintaining an audit trail, member checking, mentoring, and peer-debriefing. Patient and the public were consulted for feedback on codes, themes, and thematic maps. Thirteen participants (median age: 74 years, range: 43-90 years) with a variety of patient demographics were interviewed. Four themes were developed on QOL in CLTI: (i) 'independence as key to life satisfaction', (ii) 'change in identity when continuity is needed', (iii) 'coping with intractable disease', and (iv) 'not wanting to be alone'. Member checking with patient and public involvement confirmed the relevance and centrality of these themes to the lived experiences of patients with CLTI. The thematic outputs contribute important insights into what QOL truly means to patients with CLTI and what matters for their QOL. The content validity of the new CLTI-specific QOL instrument is improved by giving patients voice. This study highlights the value of qualitative inquiry and patient and public involvement in vascular surgical research.

Sections du résumé

BACKGROUND BACKGROUND
Quality of life (QOL) is an outcome that matters to patients with chronic limb-threatening ischemia (CLTI). However, we identified the lack of and need for a CLTI-specific QOL instrument. Our group is developing this instrument which requires a deep understanding of patient perspectives of QOL in CLTI.
METHODS METHODS
Qualitative inquiry with patient and public involvement was performed in accordance with the Standards for Reporting Qualitative Research. Reflexive thematic analysis of semi-structured interviews was conducted within a constructivist-interpretivist research paradigm. Data were organized and managed in NVivo. Techniques to enhance trustworthiness included maintaining an audit trail, member checking, mentoring, and peer-debriefing. Patient and the public were consulted for feedback on codes, themes, and thematic maps.
RESULTS RESULTS
Thirteen participants (median age: 74 years, range: 43-90 years) with a variety of patient demographics were interviewed. Four themes were developed on QOL in CLTI: (i) 'independence as key to life satisfaction', (ii) 'change in identity when continuity is needed', (iii) 'coping with intractable disease', and (iv) 'not wanting to be alone'. Member checking with patient and public involvement confirmed the relevance and centrality of these themes to the lived experiences of patients with CLTI.
CONCLUSIONS CONCLUSIONS
The thematic outputs contribute important insights into what QOL truly means to patients with CLTI and what matters for their QOL. The content validity of the new CLTI-specific QOL instrument is improved by giving patients voice. This study highlights the value of qualitative inquiry and patient and public involvement in vascular surgical research.

Identifiants

pubmed: 38012083
doi: 10.1111/ans.18791
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

429-437

Subventions

Organisme : Australian Commonwealth Government Research Training Program Scholarship
Organisme : Royal Australasian College of Surgeons Reg Worcester Research Scholarship

Informations de copyright

© 2023 Royal Australasian College of Surgeons.

Références

Guyatt GH, Ferrans CE, Halyard MY et al. Exploration of the value of health-related quality-of-life information from clinical research and into clinical practice. Mayo Clin. Proc. 2007; 82: 1229-1239.
Shan LL, Yang LS, Tew M et al. Quality of life in chronic limb threatening Ischaemia: systematic review and meta-analysis. Eur. J. Vasc. Endovasc. Surg. 2022; 64: 666-683.
Shan LL, Shi MDY, Tew M, Westcott MJ, Davies AH, Choong PF. Measuring quality of life in chronic limb-threatening ischemia patients and informal Carers: a scoping review. Ann. Surg. 2022; 276: e331-e341.
Shan LL, Wang J, Westcott MJ, Tew M, Davies AH, Choong PF. A systematic review of cost-utility analyses in chronic limb-threatening ischemia. Ann. Vasc. Surg. 2022; 85: 9-21.
Shan LLCP, Davies AH. Can quality of life predict survival and value-based Care in lower extremity arterial disease? ANZ J. Surg. 2022; 92: 1986-1987.
Kamudoni P, Johns N, Salek S. Living with Chronic Disease: Measuring Important Patient-Reported Outcomes, 1st edn, Vol. XII. Singapore: Springer, 2018; 165.
de Vet H, Terwee C, Mokkink LB, Knol D. Measurement in Medicine: A Practical Guide, 1st edn. New York, USA: Cambridge University Press, 2011; 338.
Liamputtong P. In: Liamputtong P (ed). Handbook of Research Methods in Health Social Sciences. Singapore: Springer, 2019.
Braun V, Clarke V. Novel insights into patients' life-worlds: the value of qualitative research. Lancet Psychiatry 2019; 6: 720-721.
Carlton J, Peasgood T, Khan S, Barber R, Bostock J, Keetharuth AD. An emerging framework for fully incorporating public involvement (PI) into patient-reported outcome measures (PROMs). J. Patient Rep. Outcomes 2020; 4: 4.
Staniszewska S, Brett J, Simera I et al. GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research. BMJ 2017; 358: j3453.
O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad. Med. 2014; 89: 1245-1251.
Braun V, Clarke V. Thematic Analysis: A Practical Guide. London: Sage Publications Ltd, 2021; 376.
Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual. Res. Sport Exerc. Health 2019; 13: 201-216.
Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual. Res. Psychol. 2020; 18: 328-352.
Braun V, Clarke V. Conceptual and design thinking for thematic analysis. Qual. Psychol. 2022; 9: 3-26.
Conte MS, Bradbury AW, Kolh P et al. Global vascular guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur. J. Vasc. Endovasc. Surg. 2019; 58: S1-S109.e33.
Byrne D. A worked example of Braun and Clarke's approach to reflexive thematic analysis. Qual. Quant. 2021; 56: 1391-1412.
Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis. Int. J. Qual. Methods 2017; 16: 1609406917733847.
Shan LL, Telianidis S, Qureshi MI et al. A review of illness perceptions in chronic limb-threatening ischemia: current knowledge gaps and a framework for future studies. Ann. Vasc. Surg. 2022; 87: 321-333.
Ma GW, Botros D, Summers dL L, Kayssi A. Qualitative research in vascular surgery. Semin. Vasc. Surg. 2022; 35: 438-446.
Monaro S, West S, Gullick J. The body with chronic limb-threatening ischaemia: a phenomenologically derived understanding. J. Clin. Nurs. 2020; 29: 1276-1289.

Auteurs

Leonard L Shan (LL)

Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

Stacey Telianidis (S)

Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.

Mark J Westcott (MJ)

Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

Deborah Debono (D)

Centre for Health Services Management, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Alun H Davies (AH)

Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

Peter F Choong (PF)

Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

Classifications MeSH