Table 1 Eligibility criteria in line with the SPIDER framework
| Â | Inclusion | Exclusion |
|---|---|---|
Sample | Adult patients (aged 16+) requiring, undergoing or who have undergone reconstructive surgery for a lower limb condition (leg, ankle or foot). Conditions may include: a fracture fixation which becomes infected; non-union (a fracture which does not heal); malunion/deformity (a fracture which has healed in an incorrect position); any acquired or congenital condition leading to bone deformity, leg length discrepancy or bone loss, congenital lower limb deformities, joint contracture; lower limb injuries where further limb reconstruction is required; poly-trauma patients (as long as one of the above criteria were met) Patients were included at any time point after injury or condition onset Studies with a mix of amputee and reconstruction patients were included if the results for both groups of patients could be separated | Those under the age of 16 Patients who have undergone a lower limb amputation |
Phenomenon of interest | QOL, including (but not limited to) social interactions, employment, perceived health and QOL after condition onset/injury and throughout recovery This inclusion was kept broad since defining QOL as a single entity is challenging due to individual perceptions as to what constitutes quality living [20] | – |
Design | Studies which used established qualitative methods such as interviews or focus groups and used established qualitative analytical approaches (e.g. thematic analysis, framework analysis, grounded theory) Mixed-methods studies which included a qualitative component of data collection (as described above) and analysis were eligible for inclusion if the qualitative component was clearly identifiable and suitable for extraction | Opinion pieces, commentaries, case studies, guidelines, audits, clinical observational studies, questionnaire studies, RCTs and other quantitative designs |
Evaluation | Studies reporting on patient’s attitudes, perspectives and behaviours surrounding QOL in the broadest sense. This encompassed people’s experiences of the condition (symptoms/pain/recovery), experiences of treatment, their physical, mental, emotional, social, daily and professional functioning (effect on working and any financial difficulties), as well as outcome expectations | Studies where a mixed population were included and it was not possible to separately extract the results for our population of interest |
Research type | Primary qualitative studies | – |