Predictors of quality of life among individuals who have a lower limb amputation

Abstract

Objective: The purpose of this study was to identify factors that predict an individual's subjective quality of life (QoL) after having a lower limb amputation. Design: Cross-sectional descriptive study design. Subjects: A total of 415 unilateral, above knee (27.0%) and below knee (73.0%) amputees with an average age of 61.9 years (SD ¼ 15.7) who had lost their limb related to vascular (53.0%) or nonvascular (47.0%) etiology. Methods: Medical chart review, questionnaires (Frenchay Activities Index, Interpersonal Support Evaluation List, the Center for Epidemiology Studies -Depression scale, Prosthetic Evaluation Questionnaire mobility subscale, and the Activities-specific Balance Confidence Scale) and a QoL Visual Analogue Scale were assessed using multiple linear regression analysis. Results: The analysis revealed seven significant factors (depression, perceived prosthetic mobility, social support, comorbidity, prosthesis problems, age and social activity participation) as predictors of subjects' perceived QoL. Depression explained 30% of the variation, while the full model explained 42% of the variation. Conclusion: Several modifiable characteristics influence QoL after lower limb amputation including depression and participation in daily living. This finding suggests the importance of addressing individuals' affective status to regain or maintain QoL.

Goal Management Tendencies Predict Trajectories of Adjustment to Lower Limb Amputation Up to 15 Months Post Rehabilitation Discharge

“…Similar relationships between co-morbidity and adjustment are documented elsewhere. 38,39 Individuals with bilateral amputations experienced increases in disability over time, whereas disability decreased in those with a unilateral transtibial or transfemoral amputation. Indeed, bilateral amputations have been found to impede physical functioning to a greater extent than unilateral limb loss.…”

Bilateral Transfemoral/Transtibial Amputations Due to Battle Injuries: A Comparison of Vietnam Veterans with Iraq and Afghanistan Servicemembers

“…Self-reported health status and QoL are being evaluated more commonly in various areas of medicine, including those who sustain limb loss [2,7,8,15,16]. Asano et al [2] surveyed 415 adult patients with a mean age of 61.9 years with either a transtibial or transfemoral level of amputation.…”

“…The single-item self-rated health status question is derived from the SF-36 and has been validated to predict mortality in a Veterans Administration population and the general US population [2,7,8,15]. We used the question asking the participant to classify their health as (1) excellent to very good, (2) good, (3) fair, or (4) poor.…”

“…This measure has been shown to provide valid assessment for other populations (such as those with cancer and cardiac disease) and a general US population [19,23,25]. A VAS is also an effective means to determine patient QoL for those with chronic medical problems and amputation [2,6,16,24]. The participants were asked to respond to a question on how the amputation affected their QoL at the time of the study, answering on a scale from 0 to 10.…”

“…A single-item QoL questionnaire has been used to predict mortality and hospital use, and therefore a measure of a person's overall health, and VAS QoL measures have been used as a tool to assess QoL for patients with cancer, spinal cord injury, and amputation [2,7,8,24].…”