Sexual satisfaction is an integral component of sexual health and well-being, yet we know little about which factors contribute to it among lesbian/bisexual women. To examine a proposed ecological model of sexual satisfaction, we conducted an internet survey of married heterosexual women and lesbian/bisexual women in committed same-sex relationships. Structural equation modeling included five final latent variables for heterosexual women and seven final latent variables for lesbian/bisexual women. Overall, results indicated that, for both groups of women, a similar constellation of factors (depressive symptoms, relationship satisfaction, sexual functioning, and social support) was related to sexual satisfaction. In lesbian/bisexual women, internalized homophobia was an additional factor. Contrary to expectations, the presence of children in the home and a history of childhood sexual abuse did not contribute significantly to the model for either group. Findings support the idea that gender socialization may influence sexual satisfaction more than socialization around sexual orientation. Additionally, given that for both groups of women relationship satisfaction explained a substantial amount of variance in sexual satisfaction, sexual concerns may be better addressed at the relationship than the individual level.

These findings highlight the potential value in including a brief, formal cognitive assessment in addition to a general mental status screen. Specific domains of cognitive function are differentially associated with functional outcomes and may inform amputation rehabilitation decisions.

The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict.

SI was common among those with recent LEA. Several aspects of an amputee's clinical presentation, such as physical functioning, satisfaction with functioning, and self-efficacy, were associated with SI, although depression severity was the best risk marker. A subset of the sample endorsed SI in the absence of a positive depression screen. Brief screening for depression that includes assessment of SI is recommended.