Phantom Fighters: Coping Mechanisms of Amputee Patients with Phantom Limb Pain: A Longitudinal Study

Abstract

Phantom Limb Pain (PLP) is a phenomenon commonly observed in orthopedic rehabilitation units that can have detrimental effects on patients' functioning. Psychological aspects of PLP have been widely investigated showing that some coping mechanisms are advantageous at certain points but not at others. However, the mechanisms related to positive adjustment to PLP during the course of rehabilitation have not been adequately examined. The aim of the study was to investigate the relationship between PLP and coping mechanism at two points during the rehabilitation process. Thirty one orthopedic inpatients, who had undergone lower-limb amputation following diabetic complications, rated their pain levels and mental coping strategies. The Ways of Coping Checklist, Life Orientation Test, and the McGill Pain Questionnaire, 1 -15 days post-surgery and six months post-surgery were used for evaluation. Denial was found to be negatively correlated with PLP shortly after amputation. In contrast, optimism was found to be negatively correlated with PLP six months after the surgery. Emotion-focused coping mechanisms were found to be positively correlated with PLP. It is concluded that denial during the early stages of recuperation and optimism at later stages of rehabilitation is associated with reduced PLP. Awareness of these mental processes by both medical staff and family members may enable acceptance of these processes and thus facilitate patients' rehabilitation.

Psychological Consequences in Patients With Amputation of a Limb. An Interpretative-Phenomenological Analysis

“…Pain from the phantom limb may also exacerbate feelings of depression ( Murray and Forshaw, 2013 ), cause mood dysregulation ( Trevelyan et al, 2016 ) and predispose the person to accidents ( Senra et al, 2012 ). Generally, these false sensations are reported in 50–85% of amputees, with varying intensity and duration, spanning weeks or months after surgery ( Margalit et al, 2013 ). This aspect of amputation generates frustration and stress and it can become a threat to the rehabilitation process and the psychological and physical well-being of the person.…”

Capsaicin 8% patch treatment for amputation stump and phantom limb pain: a clinical and functional MRI study

“…Several studies have reported factors that may be related to the risk of developing chronic pain following an amputation – time elapsed since amputation, 18 presence of pain before amputation, 19 higher levels of pain soon after amputation, 20 psychologic factors, 21 intensity of concomitant nonpainful phantom limb sensations, 22 and the site of amputation. 23 Objective methods have demonstrated changes in both the peripheral and central nervous systems, including neuroimaging and neurophysiologic techniques, in patients with chronic phantom pain after an amputation.…”

The examination of amputees’ psychological well-being “in the mirror” of phantom pain

“…Szilárdabb abbéli hitük, hogy nem képesek maguk irányítani sorsukat, így önmagukkal szemben jóval kritikusabbak, kevésbé érzik értékesnek magukat. Amputáció következtében a személy megcsonkítottnak, üres-nek, sérülékenynek érzi magát, sok esetben nehezen tud megküzdeni új korlátaival (Margalit, Heled, Berger, & Katzir, 2013). A tükörben végzett gyakorlatok mindezek ellenére javulást eredményeztek az önértékelésben is, de az egészséges önbizalom helyreállítása több idõt igényel.…”