GeneralORIGINAL ARTICLE

The presence of person-centered language in orthopedic-related amputation research: a cross-sectional analysis

Arjun K. Reddy, BA; Grayson R. Norris, BS; Rob Nayfa, BS; Nicholas B. Sajjadi, BS; Jake X. Checketts, DO; Jared T. Scott, DO; and Micah Hartwell, PhD
Notes and Affiliations
Notes and Affiliations

Received: August 28, 2022

Accepted: November 8, 2022

Published: December 15, 2022

  • Arjun K. Reddy, BA, 

    Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

  • Grayson R. Norris, BS, 

    Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA

  • Rob Nayfa, BS, 

    Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA

  • Nicholas B. Sajjadi, BS, 

    Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

  • Jake X. Checketts, DO, 

    Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA

  • Jared T. Scott, DO, 

    Department of Orthopedic Surgery, Oklahoma State University Medical Center, Tulsa, OK, USA

  • Micah Hartwell, PhD, 

    Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA

Abstract

Context: Amputations are routine in orthopedics, specifically during trauma and when patients have recurrent surgical site infections. When undergoing amputations, patients must combat the psychosocial factors associated with the loss of an extremity, including stigmatization.

Objectives: This study analyzes the presence of person-centered language (PCL) within amputation-related orthopedic publications in the top orthopedic journals.

Methods: We conducted a cross-sectional analysis with a database search on February 14, 2021 utilizing PubMed. Utilizing a previously published search string, we isolated studies that were published in the top 20 orthopedic journals based on the Google h5-index. In addition to the top 20 orthopedic journals, we included the top two hand and foot & ankle journals in our search to incorporate more amputation literature. Our search yielded 687 returns. The sample was then randomized, and the first 300 studies that fit our inclusion criteria were examined for prespecified non-PCL terminology.

Results: Our results show that 157 (52.2%) studies were adherent to PCL according to the American Medical Association’s Manual of Style 10th Edition (AMAMS). Of the 143 (47.7%) studies that were not adherent to PCL, 51 studies (35.7%) had more than one type of non-PCL language. The term “amputee,” which is being labeled as identity-first language (IFL), was found in 101 articles (33.7%). Further investigation found that 73.3% (74/101) of the studies containing IFL were found to have other non-PCL terms. Of the other studies in the sample, non-PCL was found 34.7% (88/199) of the time. This analysis was done due to the discrepancies in stigmatization of the term “amputee.” No statistical association was found between adherence to PCL and study characteristics.

Conclusions: Our findings show that amputation literature within the top orthopedic journals has limited adherence to PCL. Additionally, the use of the term “amputee,” which is widely accepted by the amputation community, resulted in a greater rate of non-PCL terminology within orthopedic amputation literature. Efforts should be implemented within orthopedics to avoid the use of stigmatizing language, regarding individuals that underwent amputations, to minimize psychosocial stressors.

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