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General Orthopaedics

A CONCEPTUAL FRAMEWORK OF WHAT IS IMPORTANT TO PATIENTS AFTER A LOWER LIMB RECONSTRUCTION: PROLLIT

The British Limb Reconstruction Society (BLRS) Annual Meeting 2022, Brighton, England, 24–25 March 2022.



Abstract

Introduction

We undertook a qualitative study to explore what is important to people with lower limb conditions requiring reconstruction (LLR) and how it impacted their quality of life (QOL), in order to develop a conceptual framework for a new patient reported outcome measure (PROM). This builds on a previous qualitative evidence synthesis of existing research to develop a preliminary conceptual framework as part of the Patient Reported Outcomes for Lower Limb Reconstruction (PROLLIT) study.

Materials and Methods

Patients (n=32) and Orthopaedic staff (n=23) were interviewed (November 2020-June 2021) from three centres in England using one-to-one, semi-structured interviews. Patient interviews focused on experiences during and after LLR, including impact on QOL. Staff interviews explored important outcomes and goals for patients and how the LLR impacted QOL. Recordings were transcribed verbatim and analysed using thematic analysis.

Results

The conceptual framework consists of 6 overarching factors important to patients: Pain, Identity, Work, Daily lifestyle, Emotional well-being and Support. These factors are not independent of each other, rather they're all interrelated (e.g. pain impacts identity, work, emotional well-being and daily lifestyle. Work impacts identity, pain, emotional well-being and daily lifestyle). Support from the hospital, physiotherapists and family underpins the other factors and acts as a moderator of their influence.

Conclusions

This conceptual framework displays key factors important to patients after a LLR. Further research is required to map these factors onto existing PROMs to establish whether the factors we identified are captured by existing PROMs.