Article

Decision making within amputee rehabilitation includes the assessment
of whether a patient is suitable for a prosthesis and if so, what components to
provide. This study seeks to increase understanding about clinicians'
perspectives on what factors influence these decisions.
METHOD: One-to-one
semi-structured interviews were completed with 23 experienced clinicians at their
place of work at 4 UK amputee rehabilitation centres. Thematic analysis using a
theoretical, semantic approach was used to identify key themes from the data.
RESULTS: Four key themes were identified: estimating outcome; difficulties
predicting outcome; patient choice and barriers to prescribing. There was
variation in the importance placed on each theme between individual clinicians
and services, with factors such as budget and risk aversion acting as barriers to
prescribing. Only one of the 4 centres used formal prescribing guidelines.
CONCLUSION: The results highlight the difficulties clinicians experience in
estimating outcome and suggest inequity of prosthetic provision in the UK, with
variation in the provision of high cost items. The development of national
prescription guidelines is suggested to improve equality of prosthetic provision.

Langue : ANGLAIS