A Mixed Methods Study Of The Symptom Experience Following Endovascular Treatment For Lower Extremity Peripheral Arterial Disease
Peripheral arterial disease (PAD) is one of the most understudied and undertreated diseases affecting three to ten percent of the general population. Patients with lower extremity PAD must manage multiple symptoms including pain in the hips, thighs, and calves during rest and physical activity. However, evidence is limited about patients' experience, especially following treatment. The purpose of this mixed methods study was to explore the symptom experience of individuals with peripheral arterial disease following endovascular treatment including perceptions of treatment benefit and concerns. Using a convergent parallel mixed methods study design, 65 participants (mean age = 56.9 years, 73.8% female, 95.4% white) participated in a web-based survey. Quantitative data were collected utilizing six questionnaires: a researcher developed demographic and clinical history questionnaire, the Patient Health Questionnaire 9 (PHQ-9), the Walking Impairment Questionnaire (WIQ), the San Diego Claudication Questionnaire (SDCQ), the VascuQOL-25, and the Peripheral Artery Questionnaire (PAQ). Qualitative data were collected using open-ended questions within the web-based survey. The most commonly reported symptom by participants was pain in both legs while walking. Greater age was significantly associated with less symptoms, less pain, being more active, and being more social. Men reported better physical functioning, walking ability, and overall quality of life compared to women. Participants with PHQ-9 scores indicative of depression reported greater difficulty controlling their symptoms. No significant relationships were found between having a diagnosis of diabetes and symptom experience or quality of life. Qualitative data analysis revealed four themes. One theme concerning benefits of treatment was described as continuum of benefit. The three themes related to concerns with treatment were described as outcome, process, and coping. Qualitative data supported the quantitative results related to symptom experience, gender, and depression. Qualitative data diverged with the quantitative results related to age as within the qualitative data younger participants reported more positive treatment outcomes than older participants. The findings from this study have the potential to provide better insight into the experiences of individuals with PAD and guide interventions for improved care and outcomes.
Gramling, Serena Greenhaw