A Review of Illness Perceptions in Chronic Limb-Threatening Ischemia: Current Knowledge Gaps and a Framework for Future Studies

Leonard L Shan; Stacey Telianidis; Mahim I Qureshi; Mark J Westcott; Michelle Tew; Peter F Choong; Alun H Davies

doi:10.1016/j.avsg.2022.07.024

A Review of Illness Perceptions in Chronic Limb-Threatening Ischemia: Current Knowledge Gaps and a Framework for Future Studies

Ann Vasc Surg. 2022 Nov:87:321-333. doi: 10.1016/j.avsg.2022.07.024. Epub 2022 Aug 24.

Authors

Leonard L Shan¹, Stacey Telianidis², Mahim I Qureshi³, Mark J Westcott⁴, Michelle Tew⁵, Peter F Choong⁴, Alun H Davies⁶

Affiliations

¹ Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia. Electronic address: leonard.shan3001@gmail.com.
² Department of Vascular Surgery, St. Vincent's Hospital Melbourne, Melbourne, Australia.
³ Centre for Surgical Research, Bristol Medical School, The University of Bristol, Bristol, UK.
⁴ Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
⁵ Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
⁶ Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

PMID: 36029950
DOI: 10.1016/j.avsg.2022.07.024

Abstract

Background: The aim of this study is to review illness perceptions (IPs) in chronic limb-threatening ischemia (CLTI) patients undergoing revascularization (open surgical or endovascular), major lower extremity amputation, or conservative management.

Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, WOS, and Scopus databases were searched from inception to August 20, 2021 for studies evaluating IP in CLTI according to Leventhal's common sense model (CSM). Since only 1 study was identified, a post hoc secondary literature search of MEDLINE was performed for reviews of IP in cardiovascular disease and diabetes to identify potential learning points for future research. All studies underwent narrative synthesis guided by tabulated data.

Results: One study and 7 reviews were included from the primary and secondary literature searches, respectively. Timeline and controllability were the main aspects of IP that predict prosthetic use in CLTI patients, more so at 6 months than 1 month. Other reviews in cardiovascular disease and diabetes identified important targets for future research: (1) factors that affect IP and whether IP can be used as an outcome measure, (2) relationship between IP and clinician-reported and patient-reported outcomes, and (3) methods to educate and change maladaptive IP. The importance of using valid and reliable measures of IP that encompass all components of Leventhal's' CSM was stressed.

Conclusions: Knowledge of IP in CLTI patients is severely limited in contrast to other fields in cardiovascular disease and diabetes. This review helps to close this gap by raising awareness of IP and its importance within the vascular surgical community, and by providing a framework for future studies.

Publication types

Review

MeSH terms

Amputation, Surgical
Chronic Disease
Chronic Limb-Threatening Ischemia
Diabetes Mellitus*
Endovascular Procedures* / adverse effects
Humans
Ischemia / diagnosis
Ischemia / etiology
Ischemia / surgery
Limb Salvage / methods
Peripheral Arterial Disease* / complications
Peripheral Arterial Disease* / diagnosis
Peripheral Arterial Disease* / surgery
Retrospective Studies
Risk Factors
Treatment Outcome