VASCULAR SURGERY

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

Corresponding Author

Leonard L. Shan MBBS, FRACS

[email protected]

orcid.org/0000-0003-2162-2565

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

Correspondence

Dr Leonard L. Shan, Department of Surgery, St. Vincent's Hospital, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065, Australia.

Email: [email protected]

Contribution: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Software, Visualization, Writing - original draft, Writing - review & editing

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Stacey Telianidis BBMed (Hons), MD Melb,

Stacey Telianidis BBMed (Hons), MD Melb

orcid.org/0000-0001-9049-0389

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

Contribution: Data curation, Formal analysis, Investigation, Writing - review & editing

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Mark J. Westcott MBBS, FRACS,

Mark J. Westcott MBBS, FRACS

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

Contribution: Formal analysis, Supervision, Writing - review & editing

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Deborah Debono BA (Psych Hons), GCHEdT&L, PhD,

Deborah Debono BA (Psych Hons), GCHEdT&L, PhD

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

Contribution: Conceptualization, Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Writing - review & editing

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Alun H. Davies BM BCh, DM, DSc, FRCS,

Alun H. Davies BM BCh, DM, DSc, FRCS

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

Contribution: Formal analysis, Supervision, Validation, Writing - review & editing

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Peter F. Choong MBBS, MD, FRACS,

Peter F. Choong MBBS, MD, FRACS

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

Contribution: Formal analysis, Supervision, Validation, Writing - review & editing

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Leonard L. Shan MBBS, FRACS,

Corresponding Author

Leonard L. Shan MBBS, FRACS

[email protected]

orcid.org/0000-0003-2162-2565

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

Correspondence

Dr Leonard L. Shan, Department of Surgery, St. Vincent's Hospital, Level 2, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065, Australia.

Email: [email protected]

Search for more papers by this author

Stacey Telianidis BBMed (Hons), MD Melb,

Stacey Telianidis BBMed (Hons), MD Melb

orcid.org/0000-0001-9049-0389

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

Contribution: Data curation, Formal analysis, Investigation, Writing - review & editing

Search for more papers by this author

Mark J. Westcott MBBS, FRACS,

Mark J. Westcott MBBS, FRACS

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

Contribution: Formal analysis, Supervision, Writing - review & editing

Search for more papers by this author

Deborah Debono BA (Psych Hons), GCHEdT&L, PhD,

Deborah Debono BA (Psych Hons), GCHEdT&L, PhD

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

Contribution: Conceptualization, Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Writing - review & editing

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Alun H. Davies BM BCh, DM, DSc, FRCS,

Alun H. Davies BM BCh, DM, DSc, FRCS

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

Contribution: Formal analysis, Supervision, Validation, Writing - review & editing

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Peter F. Choong MBBS, MD, FRACS,

Peter F. Choong MBBS, MD, FRACS

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

Contribution: Formal analysis, Supervision, Validation, Writing - review & editing

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First published: 27 November 2023

https://doi.org/10.1111/ans.18791

L. L. Shan MBBS, FRACS; S. Telianidis BBMed (Hons), MD Melb; M. J. Westcott MBBS, FRACS; D. Debono BA (Psych Hons), GCHEdT&L, PhD; A. H. Davies BM BCh, DM, DSc, FRCS; P. F. Choong MBBS, MD, FRACS.

Alun H. Davies and Peter F. Choong denotes joint final authors.

The corresponding author is a recipient of an Australian Commonwealth Government Research Training Program Scholarship and Australasian College of Surgeons Reg Worcester Research Scholarship.

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Abstract

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

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

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

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.

Conflict of interest

None declared.

Supporting Information

Filename

Description

ans18791-sup-0001-Supinfo.docxWord 2007 document , 297.2 KB

Data S1 Detailed Study Methodology.

Table S1: Standards for Reporting Qualitative Research Checklist.

Table S2: Overview of Reflexive Thematic Analysis.

Table S3: Braun and Clarke's updated 15-point checklist for reflexive thematic analysis.

Table S4: Guidance for Reporting Involvement of Patients and the Public (GRIPP2) Checklist.

Table S5: Interview Guide for Semi-Structured Interviews.

Table S6: Overall Dataset Familiarization Notes.

Table S7: NVivo Output for Phase 1 – Familiarizing yourself with the dataset.

Table S8: NVivo Output for Phase 2 – Coding.

Table S9: NVivo Output for Phase 3a – Generating Initial Themes.

Table S10: NVivo Output for Phase 3b – Generating Initial Themes.

Table S11: NVivo Output for Phase 4a – Developing and reviewing themes.

Table S12: NVivo Output for Phase 4b – Developing and reviewing themes.

Table S13: NVivo Output for Phase 4c – Developing and reviewing themes.

Table S14: NVivo Output for Phase 5 – Refining, defining, and naming themes.

Table S15: Summary of Themes and Sub-Themes.

Table S16: Excerpts of Patient and Public Involvement.

Figure S1: Phase 3 Thematic Map.

A: Part A

B: Part B

^ӿ†§‡Denotes themes that are carried through development as the same concept.

Figure S2: Phase 4 Thematic Map.

A: Part A

B: Part B

C: Part C

^ӿ†§‡Denotes themes that are carried through development as the same concept

Figure S3: Phase 5 Thematic Map

^ӿ†§‡Denotes themes that are carried through development as the same concept

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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Volume94, Issue3

March 2024

Pages 429-437

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

Abstract

Background

Methods

Results

Conclusions

Conflict of interest

Supporting Information

References

References

Information

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

Abstract

Background

Methods

Results

Conclusions

Conflict of interest

Supporting Information

References

References

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