Perceived shared decision-making among patients undergoing lower-limb amputation and their care teams: A qualitative study.
Chelsea Leonard, George Sayre, Sienna Williams and 4 others
PMID 37079358WHAT IT FOUND
Patients with lower-limb amputation often felt excluded from decisions about whether to amputate or at what level.
Providers recognized the value of shared decision-making but cited patient illness and emotional distress as barriers. Patients valued clear, sensitive communication.
Key findings
01Most patients did not perceive that they were included as equal partners in decisions around amputation or amputation level.
02Providers recognized the importance of incorporating patient preferences but perceived several obstacles to including patients in amputation-level decisions.
03Patients identified respectful, supportive communication and collaborative exploration of options as facilitators to their involvement in decision-making.
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
All patient participants were male Veterans, so experiences of women or non-Veterans may differ. Provider and patient participants were not recruited as pairs, so their recollections are not directly comparable. The study focused on specific components of SDM and did not evaluate every facet of the process. Results may not generalize to providers outside the Veterans Health Administration.
Declared interests
The authors disclosed no potential conflicts of interest. The study was funded by the US Department of Veterans Affairs.
The easy way to misread this
Do not interpret the providers' stated intent to include patients as evidence that patients actually felt included. The study found a significant mismatch where most patients perceived no choice or discussion, despite providers recognizing the importance of shared decision-making.