The lived experience of sequential partial foot and transtibial amputation

Abstract

Purpose: To describe the lived experience of people who have undergone sequential partial foot and transtibial amputation.

Methods: Using a narrative inquiry approach, adults with experience of sequential partial foot amputation and transtibial amputation on the same limb were sampled until data saturation. Semi-structured, face-to-face interviews were conducted and transcribed verbatim. Each interview was read, coded and a thematic summary with quotes was returned to each participant for verification. Data were triangulated through independent coding and analysis.

Results: The lived experiences of the 10 participants were characterized by three themes: enduring complications eventually resolved, health and wellbeing improved with knowledge, and advice from the lived experience. The foot complications that led to partial foot amputation often endured until after transtibial amputation, where participants reported being able to get on with their life. At the point of partial foot amputation, participants had little knowledge about the surgical procedure, likely outcomes or common risks. In the lead up to transtibial amputation, structured systems provided access to peer support and conversations with healthcare professionals. As participants’ knowledge improved, many people were able to exercise control over their healthcare decisions.

Conclusions: The lived experience highlights the importance of high-quality information and meaningful conversations to inform decision making and prepare people for life with limb loss.

IMPLICATIONS FOR REHABILITATION

1. Partial foot amputation is associated with high rates of complications and subsequent transtibial amputation

2. At the point of partial foot amputation, most people seem unaware of what the surgery involves or the likelihood of complications and reamputation

3. This research suggests that people facing the prospect of partial foot amputation may benefit from access to the structured systems already in place for most people facing transtibial amputation

4. Access to high-quality information, peer support, and meaningful conversations with healthcare providers can support informed decision making and help people prepare for the likelihood of complications and reamputation following partial foot amputation

Keywords:

• Partial foot
• transtibial
• amputation
• surgery
• experience
• shared decision making
• health literacy

Acknowledgements

We are grateful for the many participants who shared their experience of sequential partial foot and transtibial amputation to help improve the experience for others facing difficult decisions about amputation surgery.

Disclosure statement

No potential conflict of interest was reported by the authors.