From perspective to prescription : bridging stakeholder experiences in the development of a decision aid for partial hand prostheses

Carlyle, Kirsty

Thesis

From perspective to prescription : bridging stakeholder experiences in the development of a decision aid for partial hand prostheses

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Creator

Carlyle, Kirsty

Rights statement

Strathclyde Thesis Copyright

Awarding institution

University of Strathclyde

Date of award

2026

Thesis identifier

T17591

Person Identifier (Local)

202089127

Qualification Level

Doctoral (Postgraduate)

Qualification Name

Doctor of Philosophy (PhD)

Department, School or Faculty

Abstract

Partial hand prostheses offer both functional and psychosocial benefits to support people with partial hand limb difference. However, the prescription process can be complex due to factors such as unique individual presentation and a lack of education among stakeholders, including both prescribers and end users. Decision-making aids are a potential support mechanism to assist stakeholders in making decisions about treatment or prescription options. This thesis aimed to explore the use of partial hand prostheses and to develop an understanding of how devices are selected for end users. This was achieved through a series of studies that explored the experiences and views of clinicians who prescribe partial hand prostheses, and people with partial hand limb difference who have undergone prescription. A literature review found that there is no recommended set of outcome measures for assessing hand activity in the partial hand limb difference population. This finding was further supported by a survey exploring clinicians’ experiences working with individuals with partial hand difference. The survey revealed that funding often drives prescription decisions, despite clinicians viewing user-centred factors, such as occupation and hobbies, as more important. These findings informed the design of a qualitative focus group study aimed at gathering deeper insights into the challenges and perspectives of those experienced in prescribing partial hand prostheses. Shared decision making and education emerged as key themes. Following this, a decision-making aid was developed and shared with individuals using partial hand prostheses to gain their feedback, alongside insights from their own prescription journeys. This thesis presents a decision-making aid – a practical tool designed to support both users and clinicians by addressing challenges identified in the preceding studies. Validation of the decision aid is recommended to enable its implementation in clinical practice and to improve prosthetic outcomes for people with partial hand limb difference.

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