Improving shared decision-making for prosthetic care: A qualitative needs assessment of prosthetists and new lower-limb prosthesis users.
Chelsey B Anderson, Stefania Fatone, Mark M Mañago and 5 others
PMID 35622457WHAT IT FOUND
Prosthetists and new users want shared decision-making for first prostheses but struggle to align values and options.
Users need to know the journey involves socket changes and want to try components. Clinicians need better tools to elicit goals beyond walking.
Key findings
01Prosthetists find it difficult to gauge patients' lifestyle goals beyond basic walking, while patients desire resources to clarify their values before design discussions.
02Both groups identified physical trial of components and peer experience as ideal ways to form preferences, but lack of such experience is a barrier for new users.
03New users were uncertain about the rehabilitation process, particularly the need for socket replacements due to limb maturation, which affected their ability to make decisions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study excluded participants from the Department of Veteran's Affairs, so findings may not apply to VA settings. Only English-speaking participants and those with phone/internet access were included, potentially biasing results toward certain socioeconomic groups. Prosthetists were limited to private practice settings, and patients were limited to transtibial or transfemoral amputations. Qualitative findings describe perceptions and needs, not the effectiveness of any specific decision aid.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not interpret these themes as evidence that a specific decision aid improves outcomes. The study identifies needs and barriers for shared decision-making, but does not test whether addressing them changes patient satisfaction or prosthesis use.