Measuring Health Related Quality of Life has become more and more important in evaluating patients with peripheral arterial disease. This prospective longitudinal survey aimed to investigate health related quality of life over time in patients with peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA) between December 2005 and June 2008. Health Related Quality of life was assessed using the Claudication Scale (CLAU-S) and EQ5D and the Sense of Coherence Scale was used to estimate the patients' sense of coherence. The findings of this study shows that the total CLAU-S score was improved both at one-month follow-up (p < 0.0001) and one-year follow-up (p < 0.0001) compared to baseline. There were significant differences regarding all five dimensions: every day life, pain, social life, illness-specific fears and psychological wellbeing. The EQ5D computed by index improved significantly both at one-month follow-up (p = 0.0006) and one-year follow-up (p = 0.0019) compared to baseline. Differences were found between the groups with low and moderate sense of coherence (p = 0.0169) as well as between the groups with low and high sense of coherence (p = 0.0208) regarding health related quality of life (HRQoL). This study showed that PTA improves HRQoL among individuals suffering from PAD and that the effect is sustainable over time. For more accurate results, a disease-specific instrument should be used to evaluate HRQoL.
Life with peripheral arterial disease and the resulting impaired walking ability leads to major limitations in daily life and a decreased quality of life. The overall aim of this thesis was to generate understanding about the life situation among people living with peripheral arterial disease and their family members. The outcomes after percutaneous transluminal angioplasty interventions both proximal and distal to the inguinal ligament were assessed by collecting data by means of chart review using a study specific protocol. The results show a connection between proximal intervention and age as well as proximal intervention and smoking. Patients in the proximal group were younger and more frequent smokers or former smokers and hematomas/bruises as a complication were more common among non-diabetic patients (Paper I). Health related quality of life in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty intervention was investigated using a general questionnaire (EQ5D) as well as a disease-specific questionnaire (CLAU-S) translated into Swedish for this study. The health related quality of life was improved both one month and one year after the percutaneous transluminal angioplasty compared to before the intervention (Paper II). The experiences of living with intermittent claudication were studied through qualitative interviews with individuals suffering from peripheral arterial disease. The interviews were analyzed by thematic content analysis and six themes together founded a main theme concerning adjusting to a restricted life when living with intermittent claudication (Paper III). Spouses and cohabitants were interviewed about their experiences of living together with a person suffering from intermittent claudication. The overall theme was about living a demanding life when living together with someone with intermittent claudication. The findings of this study give insight into the complexities and the difficulties of ageing and living together with someone suffering from intermittent claudication (Paper IV). In conclusion, living with intermittent claudication has a major impact on daily life and demands adjustment to a restricted life. Percutaneous transluminal angioplasty improves health related quality of life among individuals suffering from peripheral arterial disease and the effect is sustainable over time up to one year after the intervention. People who had undergone percutaneous transluminal angioplasty were younger in the proximal group and hematomas/bruises were more common among nondiabetic patients. Ageing and intermittent claudication have great impact on both the spouse’s and the ill person’s life situation