Aim. To define the motivational and gender differences in patients with limb loss. Methods. 318 patients [male - 267 (83.3%), female - 51 (16.7%)] with lower limbs structural and functional deficiencies admitted for prosthetics surgery to prosthetic and orthopedics center «Reabilitaciya invalidov», Kazan, Russia, from 2008 to 2010 were included in the study. Empiric data on motivational features were gained using questionnaires and test examinations of 191 patients aged form 18 to 66 years. Quality of life, personality traits, emotional and motivational health, natural, and social and cultural environment were assessed. Results. Marked need for affiliation was typical for patients with high anxiety levels (r=0.15, p 0.05) and emotive (r=0.17, p 0.01) personalities and is decreased in rigid personalities (r=-0.26, p 0.01). There was a negative correlation between the urge of being accepted by others and the need for success (r=-0.19, p 0.05). Affiliate need in women was relevantly higher compared to men (t=2.87, p 0.05). The strong negative correlation of the need to be accepted by others and motivation for achievement was noticed in women (r=-0.46, p 0.01), in men the difference was not significant (r=-0.11). Demonstrative (r=0.21, p 0.05) and hyperthymic (r=0.24, p 0.01) personalities were more often focused on achievement and success. Pedantic (r=-0.23, p 0.01), anxious (r=-0.28, p 0.01) and cyclothymic (r=-0.28, p 0.01) traits were associated with the motivation for tranquility. Motivation for achievement was relevantly higher in men (t=-2.82, p 0.05). High personal anxiety (r=-0.38, p 0.05) and depression (r=-0.36, p 0.05) were characteristic for women with predominant tranquility motivation. A negative correlation of degree of motivation for achievement and situational (r=-0.23, p 0.01) and personal (r=-0.19, p 0.05) anxiety, as well as depression (r=-0.36, p 0.001) was found in men. This concludes that depression and anxiety decrease the willingness to success in patients of both genders. Conclusion. When planning a rehabilitation program for disabled, gender differences should be taken into account, because connection between motivation for achievement, affiliation, personal traits, emotional traits and physical activity parameters are different in men and women.
Aim. To study the physical activity in disabled patients who underwent an amputation of the lower limb in a late period of rehabilitation and prosthetics. Methods. The study included patients with structural and functional disorders of limbs. 308 patients aged 18 to 66 years were randomly selected to participate in the study as they were referred to Prosthetic and orthopedics center «Reabilitaciya invalidov», Kazan, Russia from 2008 to 2010. Patients were allocated to five age groups: 19 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years old and older than 60 years. Activity level, depending on the motor capacity was investigated in 308 patients who were offered prosthetics according to the classification subdividing locomotor activity on five levels. SF-36 questionnaire (quality of life), Spielberger-Hanin reactive and personal anxiety scales, Beck Depression Inventory, the Mehrabian Achieving Tendency Scale, Smisek-Leonhard characterological test were administered. Quality of lower limbs prostheses were assessed by «TWO LEGS» prosthesis evaluation questionnaire on a 5-point scale. Results. The majority of patients who were at the remote stage of rehabilitation after prosthesis had high level of physical activity - 141 (45.7%) patients, average activity level - 81 (26.2%) patients, reduced level of activity - 63 (20.5%) patients. High level of physical activity, depending on the locomotor activity, was more typical for the second (20-29) and third (30-39 years) age groups - 60 and 54%, respectively. Very high and high levels of physical activity was equally observed in patients with one and both amputated both lower legs: 8.4 and 7%, respectively. Conclusion. Level of amputation, age and psychological characteristics, as well as prosthesis quality and the term of prosthesis use were essential for motor activity, quality of life and functional independence of the disabled with structural and functional of the lower limb disorders.
Aim. To study the quality of life, characteristic traits and emotional features in disabled patients with functional and structural damage of limbs. Methods. Disabled patients with functional and structural damage of limbs who addressed to the center of prosthesis and ortopedy for limb prosthesis were studied. 318 patients (males - 267 (83.3%), females - 51 (16.7%), aged 18 to 66 years) with limb stumps (including congenital limb defects) who addressed to the centre since 2008 to 2010 were randomly picked out to be included in the trial. The complex study of the following context factors included in the International Classification of Functioning, Disability and Health: quality of life, individual psychological traits, emotional sphere and motivation, social, cultural and nature environment. Patients were divided into 5 groups: aged 19 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, over 60 years of age. Results. In the group of patients aged 19 to 29 years, the most intimately related to the quality of life were: situational anxiety and pedantic types demonstrative and of accentuated personality. In the group of patients aged 30 to 39 years the limitations due to amputations increased the influence on depression formation. In the group of patients aged 40 to 49 years the conjugacy of patients’ emotional and personal traits with the quality of life strengthened. Meanwhile, the influence of depression on patients’ quality of life and personality increased. n the group of patients aged 50 to 99 years the most influential was the triad of situational anxiety, personal anxiety and depression. In patients over 60 years of age quality of life was strongly related to patient’s psychologic and emotional condition, especially with situational anxiety. Conclusion. Different age groups of the patients who underwent a limb amputation, need an individualized and specialized rehabilitation programs, considering the interrelation between emotional, individual and psychological personal traits and parameters of quality of life.
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