Patient experience of the process to diagnosis of chronic limb‐threatening ischaemia: A qualitative study

Author:

Atkins Eleanor12ORCID,Kellar Ian3,Birmpili Panagiota12,Boyle Jonathan R.4,Pherwani Arun D.5,Chetter Ian2,Cromwell David A.16

Affiliation:

1. Clinical Effectiveness Unit Royal College of Surgeons of England London UK

2. Hull York Medical School Hull UK

3. University of Sheffield Sheffield UK

4. Department of Vascular Surgery Cambridge University Hospitals NHS Trust and Department of Surgery University of Cambridge Cambridge UK

5. Staffordshire & South Cheshire Vascular Network Royal Stoke University Hospital Stoke‐on‐Trent UK

6. Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine London UK

Abstract

AbstractIntroductionDelays exist at each stage of the chronic limb‐threatening ischaemia (CLTI) care pathway, but there is little known about patient factors influencing delay to diagnosis of CLTI. This study explores the experiences and perceptions of patients recently diagnosed with CLTI.MethodsA qualitative interview study was conducted. Sixteen participants underwent semi‐structured interviews. Reflexive thematic analysis was performed on the data, aiming to understand factors which can influence delay in the CLTI care pathway.ResultsFive interrelated themes were developed: CLTI is a devastating condition; Reluctance to ask for help; When we are empowered we get better care; Luck plays a role in the process to diagnosis; and Vascular units can do better, comprising sub‐themes of information transfer—consider communication and arterial versus non‐arterial centres—proximity isn't everything.ConclusionsThe five themes generated from the interview data describe factors relevant to delay given meaning by participants who have lived experience of CLTI. Theme content should be noted by clinicians, commissioners and providers looking to improve care pathways for patients with CLTI. The importance of awareness for the public, patients and clinicians linked ideas in some themes and interventions to raise awareness should be considered.

Funder

Royal College of Surgeons of England

Circulation Foundation

Publisher

Wiley

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