Patient quality of life determinants in decision-making regarding amputation

Carly Lightstone, Naomi Eisenberg, Sherry Harburn, Dorina Baston, Rima Styra, Graham Roche-Nagle

Abstract

Psychological adjustment to amputation begins well before surgery and is pivotal in determining both functional and emotional outcomes. For patients with Peripheral Arterial Disease (PAD), understanding their emotional and psychological challenges during the perioperative period is essential for healthcare teams to provide effective support.

Introduction

Peripheral Arterial Disease (PAD) is a leading cause of limb loss, accounting for approximately 82% of all amputations in the United States, with major amputations (both above-knee and below-knee) making up over half of the procedures performed annually.
Methods

A qualitative research design was employed. The study was approved by the institutional Research Ethics Board.

Results

Table 1 summarizes the demographic characteristics of our sample, which are typical for a population with peripheral artery disease (PAD), including a history of diabetes, cardiac disease, hypertension, and smoking.

Discussion

Our study offers significant insights into the emotional and psychological challenges that peripheral artery disease (PAD) patients face in the peri-operative period, particularly those undergoing amputation. The findings lend insight to the quality and conversational approach between healthcare providers (who could be a surgeon or the nurse) and patients.

Conclusion

This study highlights the critical importance of addressing both the physical and psychological needs of PAD patients in the pre-operative period. Surgeons, along with the healthcare team, play a critical role in initiating early communication about the potential need for amputation and offering pre-surgical psychoeducation to prepare patients emotionally.

Citation: Lightstone C, Eisenberg N, Harburn S, Baston D, Styra R, Roche-Nagle G (2026) Patient quality of life determinants in decision-making regarding amputation. PLoS One 21(6): e0352154. https://doi.org/10.1371/journal.pone.0352154

Editor: Nan Jiang, Southern Medical University Nanfang Hospital, CHINA

Received: July 31, 2025; Accepted: June 6, 2026; Published: June 25, 2026

Copyright: © 2026 Lightstone et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data cannot be shared publicly because of ethics board. Data are available from the UHN Institutional Data Access/Ethics Committee (contact via reb@uhn.ca) for researchers who meet the criteria for access to confidential data.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.