Patients with chronic limb-threatening ischemia: Experiences of their disease, treatment, and care in a cross-sectoral setting. A scoping review

Introduction: Patients facing chronic limb-threatening ischemia (CLTI) experience significant burdens, impacting their physical, emotional, and social well-being. They require extensive care from multidisciplinary healthcare professionals across primary and secondary settings. Managing CLTI necessitates strict patient adherence to treatment protocols to prevent severe complications. Surprisingly, previous studies have overlooked these patients' unique perspectives, highlighting the need to explore their experiences and challenges. Objective: The objective of this review was to systematically identify, examine, and conceptually map extant literature on patients with CLTI in the context of living with the condition, and explore their experiences of receiving treatment and care within a cross-sectoral setting. Methods: A systematic search was completed on 18 September 2023 with no methodological or format restrictions. We identified the population, concept, and context to pinpoint the delineate the focus of this review process. The JBI methodology for scoping reviews and the PRISMA-ScR checklist were followed. Results: Based on our search, we found ten relevant scientific qualitative and/or quantitative sources and one non-scientific source. We identified four main maps: 1) Dependency on others is my new life condition, 2) I'm more than the sum of my conditions, 3) I'm lost in chaos, be alert to all of me, and 4) Give me more time, my body and mind are under attack. Conclusion: This scoping review describes how patients’ lives are affected by CLTI and provides insights into their perception of shared decision-making, treatment, and care. The review reveals the need for a more person-centered approach to care. To nuance person-centred care further, it is necessary to consider the impact of patients’ cultural values and preferences. However, this area is marked by a notable research gap.