Decision-Making on Limb Amputation: The Patient's Point of View

Wednesday, 1 August 2012: 3:30 PM

Valeria Tzevlin, RN, BA
Vascular Surgery Department, Assaf Harofeh Medical Center, Zerifin, Israel
Einat Malul, RN, MA
Vascular Surgery Department, Assaf HaRofe Medical Center, Zerifin, Israel
Michal Rassin, PhD
Nursing Research, Assaf Harofeh Medical Center, Zrifine, Beer- Yaakov, Israel

Learning Objective 1: The learner will be able to understand how patients reach the decision to consent to the amputation of a lower limb

Learning Objective 2: The learner will be able to support the patient's in the decision-making process.

Purpose: How patients make decisions about their future treatment has been sparsely study and with respect to limb amputation, a particularly difficult decision, not at all. The purpose of the study is to reach as deep understanding as possible of how from the patients' point of view  they reach the decision to consent to the amputation of a lower limb.

Methods: The research was conducted in the qualitative method. Thirty lower-limb amputees (aged 32-88) took part in the study. In-depth interviews were held with the participants. The data were processed by means of content analysis.

Results: The main thematic categories identified were, in the chronological order of their appearance: 'The trail of torment leading to the decision to amputate', 'The turning point — taking the decision' "I just couldn't take any more pain" "We opt for life, we don't want to die". The more protracted and pain-filled the 'the trail of torment' the more mentally prepared patients were to give consent to amputation. Asked to look back on their choice, almost all interviewees had no regrets and even found virtues in it.

 Conclusion: The patients' decisions represented a mix of their grasp of the medical information supplied them by their doctors, their own personal values —opting for life prevailing over the desire for a whole body, and consideration for their family. The patients saw the decision-making process about amputation as a process of achieving consensus between themselves, their doctors and their family.