Disability, pain, and wound-specific concerns self-reported by adults at risk of limb loss: A cross-sectional study using the World Health Organization Disability Assessment Schedule 2.0

There has been limited study of patient-reported outcomes (PROs) in patients at risk of limb loss. Our primary objective was to estimate the prevalence of disability in this patient population using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). We recruited patients...

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Bibliographic Details
Published in:PloS one 2021-06, Vol.16 (6), p.e0253288-e0253288
Main Authors: Roberts, Derek J, Nagpal, Sudhir K, Forster, Alan J, Brandys, Timothy, Murphy, Christine, Jennings, Alison, Strauss, Shira A, Vishnyakova, Evgeniya, Lawson, Julie, McIsaac, Daniel I
Format: Article
Language:English
Subjects:
Anesthesiology
Biology and Life Sciences
Cardiovascular system
Care and treatment
Cognition
Computer programs
Cross-sectional studies
Data collection
Demography
Diabetes
Disease
Domains
Drafting software
Editing
Epidemiology
Ethics
Foot diseases
Funding
Health risks
Hospitals
Leg ulcers
Literature reviews
Measurement methods
Medicine
Medicine and Health Sciences
Methodology
Pain
Patients
Public health
Quality of life
Questionnaires
Schedules
Software
Surgery
Vascular diseases
Vascular surgery
Wound healing
Wounds
Wounds and injuries
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Summary:There has been limited study of patient-reported outcomes (PROs) in patients at risk of limb loss. Our primary objective was to estimate the prevalence of disability in this patient population using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). We recruited patients referred to a limb-preservation clinic. Patients self-reported their disability status using the 12-domain WHODAS 2.0. Severity of disability in each domain was scored from 1 = none to 5 = extreme and the total normalized to a 100-point scale (total score [greater than or equal to]25 = clinically significant disability). We also asked patients about wound-specific concerns and wound-related discomfort or distress. We included 162 patients. Reasons for clinic referral included arterial-insufficient (37.4%), postoperative (25.9%), and mixed etiology (10.8%) wounds. The mean WHODAS 2.0 disability score was 35.0 (standard deviation = 16.0). One-hundred-and-nineteen (73.5%) patients had clinically significant disability. Patients reported they had the greatest difficulty walking a long distance (mean score = 4.2), standing for long periods of time (mean score = 3.6), taking care of household responsibilities (mean score = 2.7), and dealing with the emotional impact of their health problems (mean score = 2.5). In the two-weeks prior to presentation, 87 (52.7%) patients expressed concern over their wound(s) and 90 (55.6%) suffered a moderate amount or great deal of wound-related discomfort or distress. In adjusted ordinary least squares regression models, although WHODAS 2.0 disability scores varied with changes in wound volume (p = 0.03) and total revised photographic wound assessment tool scores (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0253288