Identifying the values and preferences of prosthetic users: a case study series using the repertory grid technique.

PURPOSE: The matching of prosthetic devices to the needs of the individual is a challenge for providers and patients. The aims of this study are to explore the values and preferences that prosthetic users have of their prosthetic devices; to investigate users' perceptions of alternative prosthetic options and to demonstrate a novel method for exploring the values and preferences of prosthetic users. METHODS: This study describes four case studies of upper limb and lower limb high tech and conventional prosthetic users. Participants were interviewed using the repertory grid technique (RGT), a qualitative technique to explore individual values and preferences regarding specific choices and events. RESULTS: The participants generated distinctive patterns of personal constructs and ratings regarding prosthetic use and different prosthetic options available. The RGT produced a unique profile of preferences regarding prosthetic technologies for each participant. CONCLUSIONS: User choice is an important factor when matching prosthetic technology to the user. The consumer's values regarding different prosthetic options are likely to be a critical factor in prosthetic acceptance and ultimate quality of life. The RGT offers a structured method of exploring these attitudes and values without imposing researcher or practitioner bias and identifies personalized dimensions for providers and users to evaluate the individuals' preferences in prosthetic technology.

An interactive model of pain and myocardial ischemia.

The biopsychosocial model has been used to describe the intertwined factors that may act as mechanisms in cardiovascular disease, as well as those found in pain conditions. This model may also prove useful in understanding a diagnosis that overlaps these two areas, angina. This article reviews the literature related to biological, psychological, and social mechanisms of painful ischemic episodes and discusses the interactions of those variables. We propose an integrated model that incorporates the biopsychosocial mechanisms that may be responsible for the variability in pain reporting with ischemic episodes. We show how sex differences manifested in various biopsychosocial factors may interact to influence the presence of painful versus silent myocardial ischemia. We present a plan for future research to elucidate this interaction.