Suitability of 'Guidelines for Screening of Prosthetic Candidates: Lower Limb' for the Eastern Cape, South Africa: A qualitative study.
Luphiwo L Mduzana, Surona Visagie, Gubela Mji
PMID 30135914WHAT IT FOUND
Eastern Cape clinicians generally found the prosthetic screening tool comprehensive and helpful for referral and backlog management.
Some found it time-consuming and wanted changes. It is not evidence that using the tool improves patient outcomes.
Key findings
01Participants said the tool could help guide prosthetic prescription, manage the waiting list, and identify areas needing pre-prosthetic preparation.
02Usability views varied: occupational therapists called it easy to use, while some prosthetists said it needed explanation and some participants said it took too long.
03Participants identified barriers to use, including teams working separately, time constraints and resistance to change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study reports clinicians' perceptions in focus groups, not patient outcomes or tested prosthetic use. It used a convenience sample of 28 participants, and nurses and surgeons declined, so doctors who prescribe prostheses in this setting were not represented. Not all participants had used the tool with patients before the discussions. The tool has not been tested for criterion validity, reliability, sensitivity or specificity. The setting was specific to Eastern Cape public hospitals and clinics, and teamwork problems may limit transfer to other services.
The easy way to misread this
Do not read this as proof that the tool improves prosthetic selection or waitlist outcomes. The study only reports clinicians' views after training, and the tool has not been tested for validity, reliability, sensitivity or specificity.