A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION

Leggett H, Scantlebury A, Byrne A, et al. A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION. Orthop Procs. 2021;103-B(SUPP_6):21-21. doi:10.1302/1358-992X.2021.6.021

Leggett, Heather, et al. “A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION.” Orthopaedic Proceedings, vol. 103-B, no. SUPP_6, 2021, pp. 21-21., https://doi.org/10.1302/1358-992X.2021.6.021

Leggett, H., Scantlebury, A., Byrne, A., Harden, M., Hewitt, C., O'Carroll, G., Sharma, H., & McDaid, C. (2021). A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION. Orthopaedic Proceedings, 103-B(SUPP_6), 21-21. https://doi.org/10.1302/1358-992X.2021.6.021

Leggett, H., Scantlebury, A., Byrne, A., Harden, M., Hewitt, C., O'Carroll, G. et al. (2021) “A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION.” Orthopaedic Proceedings, 103-B(SUPP_6), pp. 21-21. Available at: https://doi.org/10.1302/1358-992X.2021.6.021

Leggett, Heather, Arabella Scantlebury, Ailish Byrne, Melissa Harden, Catherine Hewitt, Grace O'Carroll, Hemant Sharma, and Catriona McDaid. “A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION.” Orthopaedic Proceedings 103-B, no. SUPP_6 (2021): 21-21. https://doi.org/10.1302/1358-992X.2021.6.021

Leggett H, Scantlebury A, Byrne A, Harden M, Hewitt C, O'Carroll G, et al. A SYSTEMATIC REVIEW EXPLORING WHAT IS IMPORTANT TO PATIENTS WITH REGARD TO QUALITY OF LIFE AFTER LOWER LIMB RECONSTRUCTION. Orthop Procs. 2021 May 1;103-B(SUPP_6):21-21. https://doi.org/10.1302/1358-992X.2021.6.021

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Abstract

Introduction

Patient reported outcome measures (PROMs) are used to understand the impact of lower limb reconstruction on patient's 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 systematic review of qualitative studies (qualitative evidence synthesis) aimed to identify what is important to these patients.

Materials and 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/population studies that did not separate the findings from each group and studies not in English were excluded. Included studies were analysed using thematic synthesis. The review followed the methodological framework published by the Cochrane Qualitative and Implementation Methods Group for qualitative evidence syntheses.

Results

Nine studies met the inclusion criteria. Thematic synthesis identified two overarching themes:(1) areas of living key to QOL for lower limb reconstruction patients, with sub-themes: pain, daily functioning and lifestyle, identity, income and emotional wellbeing and (2) moving towards a new normal, with sub-themes: support, the ability to adapt and adjust and the ability to move forwards. The impact of lower limb reconstruction on QOL and recovery is complex and is influenced by a range of inter-related factors, which will affect patients to varying degrees depending on individual circumstances.

Conclusions

The impact of lower limb reconstruction on patients' QOL is complex, may change over time and is strongly linked to their recovery. This review was conducted as part of the wider ‘PROLLIT' study, which will develop a conceptual framework to identify what outcomes are important to patients and should be included in a PROM. We will then map our conceptual framework onto existing PROMS to establish whether our identified factors are captured by current PROMS. Depending on the outcome of this work, a new PROM for patients following lower limb reconstruction may be developed.