Anderson Chelsey B, Fatone Stefania, Mañago Mark M, Swink Laura A, Kittelson Andrew J, Magnusson Dawn M, Christiansen Cory L
Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO.
Department of Research, Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO.
Prosthet Orthot Int. 2024 Oct 1;48(5):565-573. doi: 10.1097/PXR.0000000000000314. Epub 2024 Mar 19.
After lower limb amputation, several prosthesis design options exist. However, prosthesis design decisions do not always reflect a prosthesis user's needs, values, and preferences.
To develop a patient decision aid (PDA) prototype for prosthetists and new prosthesis users facing prosthesis design decisions after lower limb amputation, and to assess its usability, accuracy, and comprehensibility.
Exploratory mixed methods.
PDA development was informed by a qualitative needs assessment and guided by the International Patient Decision Aid Standards. The PDA was evaluated by steering groups of experienced prosthesis users and prosthetic professionals (prosthetists and researchers) to test usability, accuracy, and comprehensibility through focus groups, individual interviews, and rating on a Likert scale ranging from 1 to 10.
The resulting PDA included 6 sections: (1) Amputation and Early Recovery, (2) Communication, (3) Values, (4) Prosthesis Design, (5) Preferences, and (6) Prosthetic Journey. Usability, accuracy, and comprehensibility were rated as 9.2, 9.6, and 9.6, respectively, by prosthetic professionals, and 9.4, 9.6, and 9.6, respectively, by prosthesis users.
The PDA incorporated guidance by relevant stakeholders and was rated favorably, emphasizing a need for shared decision-making support in prosthesis design. One challenge was determining the amount of information in the PDA, highlighting the diversity in end users' informational needs. Future iterations of the PDA should undergo beta testing in clinical settings.
A standardized, iterative method was used to develop a PDA for new lower limb prosthesis users and prosthetists when considering prosthesis design decisions. The PDA was considered useable, accurate, and comprehensible.
下肢截肢后，存在多种假肢设计方案。然而，假肢设计决策并不总是能反映假肢使用者的需求、价值观和偏好。
为面临下肢截肢后假肢设计决策的假肢师和新假肢使用者开发一种患者决策辅助工具（PDA）原型，并评估其可用性、准确性和可理解性。
探索性混合方法。
通过定性需求评估为PDA的开发提供信息，并以国际患者决策辅助工具标准为指导。由经验丰富的假肢使用者和假肢专业人员（假肢师和研究人员）组成的指导小组对PDA进行评估，通过焦点小组、个人访谈以及1至10的李克特量表评分来测试其可用性、准确性和可理解性。
最终的PDA包括6个部分：（1）截肢与早期康复，（2）沟通，（3）价值观，（4）假肢设计，（5）偏好，以及（6）假肢历程。假肢专业人员对可用性、准确性和可理解性的评分分别为9.2、9.6和9.6，假肢使用者的评分分别为9.4、9.6和9.6。
该PDA纳入了相关利益相关者的指导意见，且评价良好，强调了在假肢设计中需要共享决策支持。一个挑战是确定PDA中的信息量，这突出了终端用户信息需求的多样性。PDA的未来迭代版本应在临床环境中进行测试。
采用标准化的迭代方法为新的下肢假肢使用者和假肢师在考虑假肢设计决策时开发了一种PDA。该PDA被认为是可用的、准确的且可理解的。
