title: Issues influencing the decision to have upper limb surgery for people with tetraplegia.
abstract: METHODS
  Grounded theory.
  
  
  OBJECTIVE
  To explore to better understand the decision-making process of people with tetraplegia regarding reconstructive upper limb (UL) surgery.
  
  
  METHODS
  New Zealand.
  
  
  METHODS
  In-depth interviews with 22 people with tetraplegia, 10 of whom had UL surgery and 12 had not. Verbatim transcripts were analysed using constructivist grounded theory.
  
  
  RESULTS
  The primary reason for having reconstructive UL surgery was to improve independence and return to previous pastimes. Reasons not to have surgery were hope for further recovery or cure, and inadequate physical environment or social supports while rehabilitating. In addition, women identified the temporary loss of independence and need for increased care while rehabilitating as issues. Importantly, these issues were not static, often changing in importance or relevance over time.
  
  
  CONCLUSIONS
  The moment of making the decision for reconstructive UL surgery is elusive; therefore, multiple offers of surgery at different timeframes in an individual's life are required. In addition, flexibility in timing for surgery would allow for surgery to better coordinate with an individual's goals and priorities.
authors.affiliation: Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand. jennifer.dunn@cdhb.health.nz
authors.forename: J A
authors.initials: JA
authors.lastname: Dunn
authors.forename: E J C
authors.initials: EJ
authors.lastname: Hay-Smith
authors.forename: L C
authors.initials: LC
authors.lastname: Whitehead
authors.forename: S
authors.initials: S
authors.lastname: Keeling
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D011782:Quadriplegia / Q000150:complications / Q000601:surgery*; D019651:Plastic Surgery Procedures; D034941:Upper Extremity / Q000601:surgery*