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Major amputation is often offered as a late intervention for <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content> in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and\/or toxaemia. While a wealth of clinical outcome data on <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content> and amputation exists internationally, little is known about the patient\/family\u2010centred experience of hospitalisation to inform preservation of personhood and patient\u2010centred care planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Longitudinal qualitative study using Heideggerian phenomenology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fourteen patients and 13 family carers provided a semistructured interview after advice for major amputation. Where amputation followed, a second interview (6\u00a0months postprocedure) was provided by eight patients and seven family carers. Forty\u2010two semistructured interviews were audio\u2010recorded and transcribed verbatim. Hermeneutic phenomenological analysis followed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hospitalisation for <jats:styled-content style=\"fixed-case\">CLI<\/jats:styled-content>, with or without amputation, created a <jats:italic>sense of chaos<\/jats:italic>, characterised by <jats:italic>being fragile and needing more time for care<\/jats:italic> (fragile body and fragile mind, nurse busyness and carer hypervigilance), <jats:italic>being adrift within uncontrollable spaces<\/jats:italic> (noise, unreliable space, precarious accommodation and unpredictable scheduling) and <jats:italic>being confused by missed and mixed messages<\/jats:italic> (multiple stakeholders, information overload and cultural\/linguistic diversity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients and families need a range of strategies to assist mindful decision\u2010making in preparation for amputation in what for them is a chaotic process occurring within a chaotic environment. Cognitive deficits increase the care complexity and burden of family advocacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>A coordinated, interprofessional response should improve systems for communication, family engagement, operation scheduling and discharge planning to support preparation, adjustment and allow a sense of safety to develop. Formal peer support for patients and caregivers should be actively facilitated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.14536","type":"journal-article","created":{"date-parts":[[2018,5,18]],"date-time":"2018-05-18T19:50:11Z","timestamp":1526673011000},"page":"3530-3543","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The chaos of hospitalisation for patients with critical limb ischaemia approaching major amputation"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4172-4932","authenticated-orcid":false,"given":"Susan","family":"Monaro","sequence":"first","affiliation":[{"name":"Concord Repatriation General Hospital Concord NSW Australia"},{"name":"University of Sydney Susan Wakil School of Nursing &amp; Midwifery NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"West","sequence":"additional","affiliation":[{"name":"University of Sydney Susan Wakil School of Nursing &amp; Midwifery NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Pinkova","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital Camperdown NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice","family":"Gullick","sequence":"additional","affiliation":[{"name":"University of Sydney Susan Wakil School of Nursing &amp; Midwifery NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,27]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Existentialism: An introduction","author":"Aho K.","year":"2014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.08.097"},{"key":"e_1_2_9_4_1","unstructured":"Australian Nursing and Midwifery Federation(Ed.). 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