Perspectives on Communicating Information and Shared Decision-Making in Patients Undergoing Transtibial Amputation

Purpose: Patients undergoing lower extremity amputation often desire to take an active part in decision-making. The primary aim of this study was to explore patients' experiences of the care trajectory and information provided after a new care program was introduced. The secondary aim was to explore patients' perspectives of their involvement and participation in shared decision-making throughout the care process. The care program features new educational material, recommendations for the sagittal surgical technique, and information about a rigid removable dressing, early liner treatment, and a multidisciplinary team follow up three weeks after amputation. Methods: Fifteen participants who underwent transtibial amputation were included in the study and were interviewed two to three months post-surgery. Purposeful sampling was used, and data were analyzed with content analysis. Results: Three themes were identified: (1) the emotionally mixed experience of becoming a person with an amputation, (2) the need to be seen during the amputation process, and (3) the importance of being involved in care. Participants wanted to take a more active role in the decision-making process, and our multidisciplinary team follow up was an excellent example of shared decision-making. Printed information was appreciated, but the most crucial aspect was oral communication, given the gravity of the subject. Participants experienced a lack of continuity throughout the care trajectory. Conclusions: Individualized oral information and interaction with dedicated healthcare professionals are essential for participants undergoing transtibial amputation. Implementing a multidisciplinary team consultation pre-amputation may enhance patient involvement and promote shared decision-making.