Living a burdensome and demanding life: a qualitative systematic review of the patients experiences of peripheral arterial disease

Ukachukwu Abaraogu*, Elochukwu Ezenwankwo, Philippa Dall, Chris Seenan

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Background
Peripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population.
Aim
The aim of this study is to identify first-hand accounts of patients’ experiences of living with PAD.
Methods
Six databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients’ account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented.
Results
Fourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients’ ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients’ journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future.
Conclusions
Disease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.
Original languageEnglish
JournalPLoS ONE
DOIs
Publication statusPublished - 15 Nov 2018

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Peripheral Arterial Disease
systematic review
Surgery
walking
Walking
signs and symptoms (animals and humans)
Trajectories
pain
surgery
Pain
Intermittent Claudication
Gangrene
Therapeutics
ischemia
Secondary Prevention
limbs (animal)
quality of life
MEDLINE
trajectories
exercise

Keywords

  • peripheral arterial disease
  • quality of life, rehabilitation, symptomatic treatment, clean intermittent catheterisation, multiple sclerosis

Cite this

@article{30b1042105e34d8b8aabc37fa0e862e4,
title = "Living a burdensome and demanding life: a qualitative systematic review of the patients experiences of peripheral arterial disease",
abstract = "BackgroundPeripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. AimThe aim of this study is to identify first-hand accounts of patients’ experiences of living with PAD.MethodsSix databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients’ account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented.ResultsFourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients’ ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients’ journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. ConclusionsDisease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.",
keywords = "peripheral arterial disease, quality of life, rehabilitation, symptomatic treatment, clean intermittent catheterisation, multiple sclerosis",
author = "Ukachukwu Abaraogu and Elochukwu Ezenwankwo and Philippa Dall and Chris Seenan",
note = "Acceptance in SAN VoR replaced AAM",
year = "2018",
month = "11",
day = "15",
doi = "10.1371/journal.pone.0207456",
language = "English",
journal = "PLoS ONE",
issn = "1932-6203",
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T1 - Living a burdensome and demanding life: a qualitative systematic review of the patients experiences of peripheral arterial disease

AU - Abaraogu, Ukachukwu

AU - Ezenwankwo, Elochukwu

AU - Dall, Philippa

AU - Seenan, Chris

N1 - Acceptance in SAN VoR replaced AAM

PY - 2018/11/15

Y1 - 2018/11/15

N2 - BackgroundPeripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. AimThe aim of this study is to identify first-hand accounts of patients’ experiences of living with PAD.MethodsSix databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients’ account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented.ResultsFourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients’ ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients’ journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. ConclusionsDisease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.

AB - BackgroundPeripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. AimThe aim of this study is to identify first-hand accounts of patients’ experiences of living with PAD.MethodsSix databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients’ account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented.ResultsFourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients’ ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients’ journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. ConclusionsDisease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.

KW - peripheral arterial disease

KW - quality of life, rehabilitation, symptomatic treatment, clean intermittent catheterisation, multiple sclerosis

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DO - 10.1371/journal.pone.0207456

M3 - Article

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

ER -