Expectations of rehabilitation following lower limb amputation: a qualitative study

Abstract

Purpose: To explore the expectations of patients about to undergo prosthetic rehabilitation following a lower limb amputation. Method: Design: Qualitative study using semi structured interviews. Setting: Interviews were conducted at two district general hospitals. Participants: Eight patients who had undergone a major lower limb amputation due to vascular insufficiency were interviewed within two weeks of their amputation. All patients had been referred for prosthetic rehabilitation. Results: Five key themes emerged from the interviews: uncertainty, expectations in relation to the rehabilitation service, personal challenges, the prosthesis and returning to normality. These findings illustrate how participants faced uncertainty both pre-and postoperatively and often looked towards established amputees for the provision of accurate information.

Being In-Between

“…The patients appreciated the benefits that a prosthesis could offer such as independence and freedom; however, they still experienced a profound loss of limb and their former physical capacity (Murray & Forshaw, 2013). Focusing on patients' expectations of undergoing prosthetic rehabilitation following a leg amputation, Ostler et al (2014) found that patients experienced many unknown aspects of the process that followed. They wondered about the rehabilitation process and whether they would eventually learn to master using the prosthesis.…”

“…Regardless of etiology, a leg amputation is usually followed by major physical and psychosocial challenges that severely influence the person concerned (Murray & Forshaw, 2013;Norlyk, Martinsen, & Kjaer-Petersen, 2013;Ostler, Ellis-Hill, & Donovan-Hall, 2014;Washington & Williams, 2016). Reduced quality of life (Davidson, Khor, & Jones, 2010;Remes et al, 2010), significantly higher levels of social isolation, depression, and post-traumatic disorder (Horgan & MacLachlan, 2004;Remes et al, 2010) are reported particularly in the first year after the amputation (Phelps, Williams, Raichle, Turner, & Ehde, 2008).…”

“…A growing number of studies highlights the importance of psychosocial support together with physical rehabilitation in facilitating patients' prosthesis use (Coffey, Gallagher, Horgan, Desmond, & MacLachlan, 2009;Ostler et al, 2014;Schaffalitzky et al, 2011). Ostler et al (2014), for example, pointed to a need for psychoeducation interventions and concluded that, within prosthetic rehabilitation, "more time should be dedicated to talking, rather than just walking" (p. 1174).…”

“…Reported rates of prosthetic use can vary from 49% to 95% (Schaffalitzky et al, 2011), and there is an ongoing concern in lower limb prosthetic rehabilitation with underuse and non-use of artificial limbs (Murray, 2009;Schaffalitzky et al, 2011). A growing number of studies highlights the importance of psychosocial support together with physical rehabilitation in facilitating patients' prosthesis use (Coffey, Gallagher, Horgan, Desmond, & MacLachlan, 2009;Ostler et al, 2014;Schaffalitzky et al, 2011). Ostler et al (2014), for example, pointed to a need for psychoeducation interventions and concluded that, within prosthetic rehabilitation, "more time should be dedicated to talking, rather than just walking" (p. 1174).…”

Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation: A qualitative study

“…Patients who undergo nontraumatic major lower extremity amputation face changes to most aspects of their daily life. These extend beyond the physical changes associated with extremity loss and involves loss of social mobility, socioeconomic status, independence and identity (Norlyk, Martinsen, & Kjaer-Petersen, 2013;Ostler, Ellis-Hill, & Donovan-Hall, 2014). Prior to amputation, illness may cause stress metabolism inducing a catabolic state with loss of muscle and appetite increasing the risk of malnutrition (Jensen, 2010;Preiser, Ichai, Orban, & Groeneveld, 2014).…”