Preferences for rehabilitation services among women with major limb amputations

Abstract

Purpose: We present five cases of adult females with major limb amputations, their concerns and preferences for services across the life span. Design: A convenience sample of five veteran and nonveteran women aged 19-58 with major limb amputations participating in a regional VA Prosthetics Conference in 2010 took part in a panel interview. Findings: The concerns identified by these women as high priorities included independence and participation in a full range of life activities, limitations in access, patient decision-making and body image concerns, and preferences for selected services. Maximizing function and quality of life for women amputees requires identifying patient preferences for rehabilitation and prosthetic services. Lessons learned could inform development of clinic-based rehabilitation care, prosthetic services, and studies of women with major limb amputations. Conclusions: As the current conflicts in Iraq and Afghanistan wind down, the number of women veterans seeking rehabilitation and prosthetic services will increase. With this information, rehabilitation and prosthetic service providers and organizations will be uniquely positioned to provide prevention and treatment of amputations for this growing population of women veterans in national care delivery systems and in communities. Clinical Relevance: An open-ended facilitated discussion among a panel of women with major limb amputations provided insights for providers and organizations with respect to needs, concerns, and preferences for rehabilitation and prosthetic services. Background and Significance

A National Survey of Prosthesis Use in Veterans with Major Upper Limb Amputation: Comparisons by Gender

“…These findings are consistent with earlier reports that women with upper limb amputation were more likely to reject devices outright and never use them 10,29 . Women in prior studies have expressed preferences for, and challenges in obtaining, appropriately gendered prostheses that are smaller sized and look more feminine 30–32 …”

Sex‐specific Differences in Multisite Pain Presentation among Adults with Lower‐Limb Loss

“…Historically, prosthetic componentry has been largely designed to accommodate male build and body mass 12 . While we did not find significant differences in self‐reported socket comfort between males and females at the time of the evaluation ( Z = −0.466, P = 0.642), other prosthesis‐related issues (eg, heavy weight, poor suspension, malalignment) may be more prevalent among females 28 and may increase demands on the intact limb or low back. Further investigation into relationships among pain, sex, and prosthetic fit and functionality may help identify mechanisms underlying sex‐specific differences in secondary pain prevalence.…”

Delivery of cosmetic covers to persons with transtibial and transfemoral amputations in an outpatient prosthetic practice

“…transfemoral compared with transtibial levels). [7][8][9] Through qualitative analyses, Murray 5 reported that cosmesis may be prioritized partially in relation to etiology and gender, with the latter being counter to Miller's 7 findings, but in agreement with Elnitsky et al 10 It seems plausible that certain demographic variables are related to body image perception. However, based on previous studies which used standardized survey instruments and qualitative analyses, demographic differences are not eminently clear.…”