Understanding amputation care in England and Scotland: a qualitative exploration of patient stories posted on an online patient feedback site

Abstract

Purpose

Undergoing an amputation is a life-altering experience that can involve a protracted and intensive period of care from a range of healthcare professionals. Amputation care within the NHS has historically been criticised. Here we seek to understand how patients are experiencing care by exploring their stories and identifying features of both high- and low-quality care.

Materials and methods

We analysed patient stories posted on the patient feedback site Care Opinion during the period 2018–2020 to examine how amputee patients (and their families) experience NHS care. Using thematic analysis, we identified four key themes.

Results

We found that patients’ stories of undergoing an amputation as posted on Care Opinion give overwhelmingly positive feedback on their experiences. Patients report feeling well-supported by empathetic staff, and that the outcomes, in terms of quality of life and restoration of mobility, are beneficial. Time was a common feature within the posts we examined and negative experiences of care often related to untimeliness in a variety of ways.

Conclusions

Care Opinion provides a useful and accessible resource for understanding how patients experience amputation care; analysis of stories posted there provides preliminary ideas of the features of “good care” from a patient-centred perspective.

IMPLICATIONS FOR REHABILITATION

• Patients undergoing amputations view professionalism of staff as important for good care.

• Timeliness is important to patients in seeing care in positive terms, ensuring patients are supported in their care during and after amputation in a timely manner is therefore important for achieving good rehabilitation care.

• Rehabilitation and related services supporting patients who have undergone amputations could usefully patient feedback sites as a means for further understanding the experiences of their patients and for improving services where necessary.

Keywords:

• Amputation
• patient feedback
• care experiences
• qualitative research
• internet mediated research

Disclosure statement

There is no funding to report for this work, and the authors declare no conflicts of interest.

Notes

1 For example, see https://evidence.nihr.ac.uk/alert/online-patient-feedback-is-mostly-positive-but-is-not-being-used-effectively/.

2 Number of posts accurate as of 28 October 2020, but as a live platform the number of posts on the site is growing month on month.

3 See https://blogs.bmj.com/medical-ethics/2019/08/01/the-ethics-of-disposing-of-amputated-limbs/.

4 See https://www.vsqip.org.uk/content/uploads/2020/11/NVR-2020-Annual-Report.pdf.

Additional information

Funding

This work was funded by NIHR grant NIHR300631.