The experiences and needs of people with dysvascular lower extremity amputations: a qualitative systematic review and meta-synthesis

PurposeThe aim of this review is to synthesise the experiences and needs of people who had undergone dysvascular lower extremity amputations. Given the increasing global prevalence of vascular diseases like diabetes mellitus and peripheral arterial disease, the risk of requiring an amputation remains high.Materials and methodsThis systematic review follows the PRISMA and ENTREQ reporting guidelines. Seven databases were searched for qualitative studies from January 2011 to October 2023. In total 6435 studies were obtained, where 1146 were duplicates and 5271 studies failed to meet the eligibility criteria. The remaining 18 studies were synthesised using Sandelowski and Barroso's approach and appraised using the CASP checklist.ResultsFour themes emerged from the meta-synthesis: (1) making the decision to amputate, (2) difficulties in the physical adaptation to limb loss, (3) psychosocial consequences of living with an amputation, and (4) regaining control and building hope.ConclusionsHaving dysvascular lower extremity amputations is a complicated experience as not only was the pre-amputation pain relieved, but a new set of physical, emotional and social challenges would surface after the amputation. These synthesised findings serve as a platform to explore the factors behind the various experiences faced by these people and how healthcare professionals can help them in their adjustment. Dysvascular lower extremity amputations can affect the physical and mental well-being of people who have experienced them.Healthcare professionals (HCPs) are encouraged to individualise care that meets the physical and emotional needs of patients.Sufficient time and information should be provided before the operation for these people to be better prepared for the changes following the amputation.Physical support by HCPs should include physical rehabilitation, checking on the wound healing and managing any existing co-morbidities.Emotional support can be given through additional referral to medical social workers or psychologists and the involvement of support groups.