{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T07:30:52Z","timestamp":1771054252386,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>To explore person and family lifeworld narratives of chronic limb\u2010threatening ischaemia (CLTI) after major amputation has been offered as a treatment option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic limb\u2010threatening ischaemia manifests as ischaemic pain, ulceration and\/or gangrene and is receiving heightened attention due to the increasing health system burden from associated complex wounds and hospitalisations for repeat procedures. The patient and family impact of these manifestations is not well\u2010reported: current studies largely seek to measure treatment outcomes. Patient\u2010reported outcome measurements need to be developed but should be underpinned by rigorous qualitative research.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, longitudinal, qualitative design using interpretive phenomenology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The journeys of 19 people with CLTI were explored via 42 semi\u2010structured interviews with 14 patient and 13 family participants. The initial interview was conducted soon after the advice of the need for major amputation, and where amputation followed, participants were invited for a second interview 6\u00a0months postprocedure. Hermeneutic phenomenological analysis was guided by Merleau\u2010Ponty's philosophy of embodiment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>People with embodied CTLI faced an existential crisis due to the catastrophic impact of creeping decay of their flesh and vascular system, relentless pain and a sense of spreading poison from gangrene, infection and drugs, which disrupted the interleaving of the physical and existential body. Consequent to the creeping decay and surgery, participants also experienced shifting body boundaries and an unreliable body.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The lifeworld of the patient and family living with CTLI is irrevocably altered through the disruption of a spontaneous and reliable body. This shapes subsequent therapeutic relationships and discourse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>People facing CLTI require early patient\u2010 and family\u2010centred discussions about the possibility for major amputation and its potential to arrest the further decline of the body and to support the body's existential expression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15151","type":"journal-article","created":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T13:25:04Z","timestamp":1577453104000},"page":"1276-1289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The body with chronic limb\u2010threatening ischaemia: A phenomenologically derived understanding"],"prefix":"10.1111","volume":"29","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":"Faculty of Medicine and Health Sydney Nursing School University of Sydney Camperdown NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"West","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Nursing School University of Sydney Camperdown NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice","family":"Gullick","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Nursing School University of Sydney Camperdown NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207456"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.05.055"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.08.097"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.01.010"},{"key":"e_1_2_8_6_1","first-page":"25","article-title":"Diabetic foot ulcer pain: The hidden burden (Part two)","volume":"11","author":"Bradbury S. E.","year":"2011","journal-title":"EWMA Journal"},{"key":"e_1_2_8_7_1","first-page":"62","article-title":"Justification of intervention for limb\u2010threatening ischemia: A surgical decision analysis","volume":"7","author":"Brothers T.","year":"1999","journal-title":"Vascular"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1062-0303(96)80025-2"},{"key":"e_1_2_8_9_1","unstructured":"Centre for Disease Control(2011)Health-Related Quality of Life.https:\/\/www.cdc.gov\/hrqol\/concept.htm"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0104-11692007000200021"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2012.01.025"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.02.016"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2017.01.029"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2018.06.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2006.03898.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1708538115578961"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S209241"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1998.00599.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1375\/jsc.1.1.7"},{"key":"e_1_2_8_20_1","volume-title":"Lund studies in arts and cultural sciences","author":"Guunarson M.","year":"2016"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794109348686"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12956"},{"key":"e_1_2_8_23_1","volume-title":"Liddell & Scott's Lexicon","author":"Liddell & Scott","year":"1963"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2006.06.008"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2010.03256.x"},{"key":"e_1_2_8_26_1","volume-title":"Phenomenology of perception","author":"Merleau\u2010Ponty M.","year":"1945"},{"key":"e_1_2_8_27_1","volume-title":"The visible and the invisible","author":"Merleau\u2010Ponty M.","year":"1968"},{"key":"e_1_2_8_28_1","first-page":"99","article-title":"Lived experience and management of the every\u2010day life after lower\u2010limb amputation caused by vascular diseases","volume":"23","author":"Mohler R.","year":"2010","journal-title":"Pflege"},{"key":"e_1_2_8_29_1","volume-title":"Susan Wakil School of Nursing & Midwifery, Faculaty of Medicine and Health","author":"Monaro S.","year":"2018"},{"key":"e_1_2_8_30_1","first-page":"17","article-title":"Patient outcomes following lower leg major amputations for peripheral arterial disease: A series review","volume":"15","author":"Monaro S.","year":"2017","journal-title":"Journal of Vascular Nursing"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13623"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.14536"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvn.2012.02.002"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2007.07.039"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X07084911"},{"key":"e_1_2_8_36_1","first-page":"112","volume-title":"Survival and quality of life among patients with severe lower extremity peripheral arterial disease","author":"Remes L.","year":"2010"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2007.02206.x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.05.087"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.05.136"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794104041110"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7489(00)00047-X"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/1538574418770849"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvn.2016.11.002"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2006.11.006"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2005.03499.x"},{"key":"e_1_2_8_47_1","unstructured":"World Health Organisation. (2016a)Global Health Observatory data repository: Tobacco use: Data by country."},{"key":"e_1_2_8_48_1","unstructured":"World Health Organisation. (2016b)Global Report on Diabetes."}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjocn.15151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.15151","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocn.15151","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.15151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T02:32:12Z","timestamp":1693967532000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocn.15151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,3]]},"references-count":47,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1111\/jocn.15151"],"URL":"https:\/\/doi.org\/10.1111\/jocn.15151","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,3]]},"assertion":[{"value":"2019-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}