1
|
Lee SP, Maluotoga M, Thind R, Lindsay L, Bhatta T, Miller CA. Utilization and Perception of Peer-Support After Lower Limb Loss in the United States: Potential Benefits on Mobility Outcomes. Arch Phys Med Rehabil 2024; 105:939-946.e3. [PMID: 38242299 PMCID: PMC11069449 DOI: 10.1016/j.apmr.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/30/2023] [Accepted: 12/14/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To examine participants' experiences with peer-support after lower limb loss (LLL) and the associations between the peer-support experience (perceived benefits and barriers) and mobility outcomes. DESIGN Quantitative and qualitative descriptive study with a cross-sectional design. SETTING National survey (distributed to 169 peer-support groups in 44 states in the US). PARTICIPANTS The survey was completed by 82 individuals with a major lower limb amputation (53% female, 54% over 55 years of age; N=82). MAIN OUTCOME MEASURES A 32-item survey to examine respondents' experiences in peer-support activities. Prosthetic mobility was measured using the Prosthetic Limb Users Survey of Mobility (PLUS-M). RESULTS Two out of 3 respondents received some forms of peer-support after amputation. Among them 75% reported peer-support having a positive effect on their outlook on life, and 78% reported that information gained from peer-support was helpful. Companionship, altruistic acts, and gaining information on how to cope with amputation were the top themes of why respondents enjoyed the peer-support experience. Nearly all (94%) respondents would recommend peer-support to other people with LLL. Individuals who received peer-support exhibited a trend of greater mobility (55th vs 36th percentile on PLUS-M; P=.055). CONCLUSION Individuals with LLL reported generally positive experiences regarding their engagement in peer-support activities. Peer-support groups are viewed as a helpful source for both information and emotional support, potentially benefiting functional and psychological recovery after amputation. Individuals who have received peer-support also exhibited greater mobility.
Collapse
Affiliation(s)
- Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV.
| | - Moriah Maluotoga
- Department of Physical Therapy, University of Nevada, Las Vegas, NV
| | - Roopkiran Thind
- Department of Physical Therapy, University of Nevada, Las Vegas, NV
| | | | - Tirth Bhatta
- Department of Sociology, University of Nevada, Las Vegas, NV
| | | |
Collapse
|
2
|
Milosevic S, Strange H, Morgan M, Ambler GK, Bosanquet DC, Waldron CA, Thomas-Jones E, Harris D, Twine CP, Brookes-Howell L. Rehabilitation experiences following major lower limb amputation due to complications of vascular disease: a UK qualitative study. Disabil Rehabil 2024:1-10. [PMID: 38622944 DOI: 10.1080/09638288.2024.2329747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Rehabilitation experiences of lower limb amputees with poorer physical health have not been fully explored. This study aimed to qualitatively explore experiences of rehabilitation amongst patients who had recently undergone amputation due to complications of vascular disease. METHODS Semi-structured, face-to-face interviews were conducted with 14 patients participating in the PLACEMENT randomised controlled feasibility trial (ISRCTN: 85710690; EudraCT: 2016-003544-37), which investigated the effectiveness of using a perineural catheter for postoperative pain relief following major lower limb amputation. Framework analysis was used to identify key themes and compare participant data. FINDINGS Three main themes and corresponding sub-themes were identified: (i) other patients as inspiration; (ii) other patients as competition; and (iii) imagined futures. Perceptions relating to other patients played a key role in rehabilitation, providing a source of motivation, support, and competition. Participants' imagined futures were uncertain, and this was compounded by a lack of information and delays in equipment and/or adaptations. CONCLUSIONS Findings highlight the importance of fellow patients in supporting rehabilitation following lower limb amputation. Enabling contact with other patients should thus be a key consideration when planning rehabilitation. There is a clear unmet need for realistic information relating to post-amputation recovery, tailored to the needs of individual patients.
Collapse
Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Heather Strange
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Melanie Morgan
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Graeme K Ambler
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - David C Bosanquet
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | | | - Emma Thomas-Jones
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Christopher P Twine
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | | |
Collapse
|
3
|
Ramstrand N, Sterner A, Palmér L. Lower limb prosthesis users' perceptions of everyday life-A phenomenographic study. Prosthet Orthot Int 2024; 48:115-121. [PMID: 37318282 DOI: 10.1097/pxr.0000000000000246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/23/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION A lack of understanding of personal experiences related to limb amputation and prosthetic use limits the extent to which clinicians involved in rehabilitation can support and advise their clients in a person-centered consultation. The objective of this qualitative study was to explore the personal experience of daily life as a lower limb prosthesis user. METHODS Fifteen lower limb prosthesis users participated in individual semistructured interviews. Transcripts were analyzed using a phenomenographic approach. RESULTS The extent to which prosthesis users were able to adjust to their impairment and move on with their life was influenced by social interactions with other prosthesis users, access to relevant information about prosthetic solutions that may benefit them, and finding a balance between desired activities and their physical and/or cognitive capacity. CONCLUSIONS After a period of existential adjustment, prosthesis users described themselves as living active, fulfilling lives. This was facilitated to a large extent by social interactions with other prosthesis users and access to information they perceived as relevant. Social media plays a particularly important role in establishing connections with other prosthesis users and is perceived as a useful source of information.
Collapse
Affiliation(s)
- Nerrolyn Ramstrand
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anders Sterner
- Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Lina Palmér
- Department of Caring Science, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| |
Collapse
|
4
|
Costa-Parke A, Di Lella A, Walker A, Verweel L, MacKay C. Peer Support for Individuals with Major Limb Loss: a Scoping Review. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2023; 6:42170. [PMID: 38873011 PMCID: PMC11168607 DOI: 10.33137/cpoj.v6i1.42170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2003] [Accepted: 12/24/2003] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Major limb loss can have profound physical and psychosocial implications for individuals, impacting their quality of life and well-being. Despite the effectiveness of peer support in improving outcomes for various chronic conditions, its impact on individuals with major limb loss remains understudied. OBJECTIVES This review aims to explore the existing literature on peer support for individuals with major limb loss. Specifically, exploring how the literature defines peer support; examining its implementation, identifying outcomes measured in peer support interventions, assessing the benefits for individuals with major limb loss, and identifying barriers associated with peer support provision. STUDY DESIGN This review followed Arksey and O'Malley's methodological framework, analysing relevant literature to identify evidence, definitions, and key factors related to peer support for individuals with major limb loss. METHODOLOGY A comprehensive search in January 2023 utilized databases: MEDLINE, PsychInfo, Embase, and CINAHL. After a two-phase screening process, articles meeting specific criteria were included. Thematic and descriptive numerical analyses were applied to the extracted data. FINDINGS Twenty-two articles were reviewed. Peer support was described as an opportunity to provide education, advice, and encouragement between individuals with lived experiences. Across the two intervention-based studies investigating peer support programs, outcome measures included physical, psychological, social, and quality of life. Qualitative studies described perceived benefits as improved psychosocial well-being and the opportunity to exchange knowledge. Perceived barriers included a lack of formal training and male-dominated groups, which deterred individuals with amputation from participating. CONCLUSION The evidence from the findings of the review sheds light on the current understanding of peer support for individuals with amputation. Due to the limited number of studies available, future research is necessary to develop and evaluate the effectiveness of peer support interventions tailored to this population.
Collapse
Affiliation(s)
- A Costa-Parke
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - A.M Di Lella
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - A Walker
- West Park Healthcare Centre, Toronto, Canada
| | - L Verweel
- West Park Healthcare Centre, Toronto, Canada
| | - C MacKay
- West Park Healthcare Centre, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| |
Collapse
|
5
|
Keeves J, Hutchison A, D'Cruz K, Anderson S. Social and community participation following traumatic lower limb amputation: an exploratory qualitative study. Disabil Rehabil 2023; 45:4404-4412. [PMID: 36448299 DOI: 10.1080/09638288.2022.2152114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE To explore barriers and facilitators to social and community participation experienced by people following traumatic lower limb amputation (LLA). METHODS An exploratory qualitative study was conducted with nine adults with traumatic LLA in Victoria, Australia. Participants were a minimum of 18 months post amputation. Interview data was analysed using thematic analysis. RESULTS Participants referenced the inaccessibility of the built environment and physical challenges associated with prosthetic mobility as barriers to participation. Chronic and complex health concerns due to their injuries resulted in physical and emotional distress for some, further limiting their social and community engagement. Participants highlighted the benefit of peer-support networks and the value of supportive community groups in assisting the transition to their pre-amputation family, work and social roles. Participants also felt that a strong, positive attitude and being self-motivated were important to aid in their return to social and community participation. CONCLUSION People following traumatic LLA experience a number of physical, psychological and environmental challenges to participation. The role of peer-support networks, community groups and personal attitudes are important facilitators to assist a return to family, work and life roles. The findings of this study have informed the development of recommendations to guide clinical practice.IMPLICATIONS FOR REHABILITATIONPeer-support groups for people following traumatic lower limb amputation (LLA) may assist to improve their long-term adjustment to disability and community participationRetraining skills in an individual's own community should be considered when planning community-based therapy services for people following traumatic LLA.Ongoing psychosocial support including strategies to develop self-efficacy and positive mindset may improve social and community participationRegular medical and allied health reviews can be beneficial to promote early intervention for any complications that arise to minimise time off prosthesis.
Collapse
Affiliation(s)
- Jemma Keeves
- Epworth Hospital, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Abby Hutchison
- Epworth Hospital, Melbourne, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Kate D'Cruz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Sarah Anderson
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| |
Collapse
|
6
|
Mayo AL, Fung V, Hitzig SL, Gould S, Posa S, Summers deLuca L, Kayssi A. Exploring the psychosocial needs of persons with lower extremity amputation and feasibility of internet cognitive behavioural therapy: a qualitative study. Disabil Rehabil 2023; 45:4025-4034. [PMID: 36377342 DOI: 10.1080/09638288.2022.2144492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Following major lower extremity amputation (LEA), patients experience significant emotional distress and are at risk for anxiety and depression. There is a lack of mental health supports for this population, and internet-based cognitive behavioural therapy (iCBT) may be a useful resource to meet this need. The purpose of this study was to use a qualitative approach to explore the mental health needs of LEA patients and to gauge their attitudes of the use of iCBT to help them cope with their amputation. METHODS Semi-structured qualitative interviews were conducted with inpatients and outpatients with LEA recruited from a major urban rehabilitation hospital. Data were analysed using inductive codebook thematic analysis (TA). RESULTS Ten interviews were completed with individuals with LEA. The main themes identified were: (1) Fixating on the past; (2) Worry about the future; (3) Unmet mental health needs; (4) Barriers to Mental Health Support; (5) Importance of peer support; and (6) Tailoring iCBT. CONCLUSIONS Our findings highlight that patients with LEA are open to learning more about iCBT to meet their mental health needs. Key iCBT implementation considerations include taking into account issues of stigma associated with mental health, timing of delivery, levels of digital literacy, online security, and interactive content.IMPLICATIONS FOR REHABILITATIONFollowing lower extremity amputation (LEA), people experience significant emotional distress and are at risk for the development of anxiety and/or depression.Patients with LEA are receptive to an online mental health resource (i.e., internet-based cognitive behavioural therapy [iCBT]) but it needs to be tailored to meet the various mental health needs and digital literacy of the LEA population.The use of an implementation science approach can help identify factors related to the development and potential uptake of an iCBT for patients with LEA.
Collapse
Affiliation(s)
- Amanda L Mayo
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vera Fung
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sarah Gould
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Stephanie Posa
- St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Leslie Summers deLuca
- Schulich Heart Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Ahmed Kayssi
- Schulich Heart Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Division of Vascular Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| |
Collapse
|
7
|
Hutchison A, D'Cruz K, Keeves J, Ross P, Anderson S. Barriers and facilitators to community reintegration in adults following traumatic upper limb amputation: an exploratory study. Disabil Rehabil 2023:1-11. [PMID: 37723859 DOI: 10.1080/09638288.2023.2256667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE To explore barriers and facilitators to community reintegration experienced by people following traumatic upper limb amputation (ULA). METHODS An exploratory qualitative study was conducted with ten adults with major ULA due to trauma. Data from individual, semi-structured interviews was analysed using Braun and Clarke's reflexive thematic analysis. RESULTS Underlying and influencing community reintegration for participants, was a process of adjustment to the impacts of amputation on everyday function and re-establishing their identity. Participants felt social networks and peer support facilitated the return to social and community activities, as did drawing on personal attributes such as positivity, resilience and self-belief. Prosthetic devices were facilitative for community reintegration by minimising visible differences and unwanted attention through restored cosmesis and in the performance of functional tasks to fulfil social norms and meaningful roles despite issues with comfort and function. Despite the adaptation and evolution of abilities, perspectives and identities, the functional impact of ULA on everyday community activities was an ongoing challenge for all participants. CONCLUSION ULA has a significant and lifelong impact on an individual's ability to complete tasks and fulfil meaningful roles in the community. Recommendations based on the study's findings will inform clinicians to support community reintegration for people following traumatic ULA.
Collapse
Affiliation(s)
- Abby Hutchison
- La Trobe University, Melbourne, Victoria, Australia
- Epworth Healthcare, Melbourne, Victoria, Australia
| | - Kate D'Cruz
- La Trobe University, Melbourne, Victoria, Australia
| | - Jemma Keeves
- Epworth Healthcare, Melbourne, Victoria, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Pamela Ross
- Epworth Healthcare, Melbourne, Victoria, Australia
| | | |
Collapse
|
8
|
Brusco NK, Foster S, Noonan M, Waugh F, Warren N. What is the cost, impact, and willingness to pay for an Amputee Peer Support Program? Prosthet Orthot Int 2023; 47:137-146. [PMID: 36607277 DOI: 10.1097/pxr.0000000000000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/08/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The provision of peer support from those who have already made positive adjustments to amputation is recommended for people incurring a major limb amputation; however, few receive this service. OBJECTIVE From a program perspective, determine the cost, impact, and willingness to pay for an Amputee Peer Support Program. STUDY DESIGN Cost analysis. METHODS Cost of the Amputee Peer Support Program included a cost analysis of program data over a 5-year time horizon (2013-2018) reported in Australian Dollars 2018/2019. Impact and willingness to pay for an Amputee Peer Support Program was determined through surveys of the 3 participant groups: referring health professionals, program volunteers, and program participants. RESULTS Over 5 years, there were 793 program participants, serviced by 256 program volunteers, for a cost of $631,497. The cost per program participant was $796. Thirty-eight health professionals, 86 program volunteers, and 12 program participants reported on impact and willingness to pay. The Program was reported to have a positive impact on all participant groups. The themes of access to resources and information and the provision of social and emotional well-being were identified across all 3 groups as being important. All 3 groups reported a higher willingness to pay for the health service (range $113-$450), National Disability Insurance Scheme ($156-$432), and private health insurance ($153-$347), and a lower willingness to pay for the program participant ($23-$49). CONCLUSION Amputee peer support had a positive impact on those receiving and providing the service. Amputee peer support is likely to be a powerful yet inexpensive addition to routine care.
Collapse
Affiliation(s)
- Natasha K Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Australia
| | | | | | | | - Narelle Warren
- School of Social Sciences, Faculty of Arts, Monash University, Clayton, Australia
| |
Collapse
|
9
|
Wasilewski MB, Rios J, Simpson R, Hitzig SL, Gotlib Conn L, MacKay C, Mayo AL, Robinson LR. Peer support for traumatic injury survivors: a scoping review. Disabil Rehabil 2022:1-34. [PMID: 35680385 DOI: 10.1080/09638288.2022.2083702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Peers are uniquely able to draw on their lived experiences to support trauma survivors' recovery. By understanding the functions and outcomes of peer support and the factors that impact implementation, evidence can be mobilized to enhance its application and uptake into standard practice. As such, we aimed to review the literature on peer support for trauma survivors to: examine the role of peer support in recovery; describe the nature and extent of peer support; Examine the influence of peer support on health and well-being; and identify the barriers and facilitators to developing and implementing peer support. METHODS Scoping review methodology as outlined by Arksey and O'Malley. RESULTS Ninety-three articles were reviewed. Peer support was highlighted as an important component of care for trauma survivors and provided hope and guidance for the future post-injury. Most peer support programs were offered in the community and provided one-on-one support from peer mentors using various modalities. Interventions were successful when they involved knowledgeable peer mentors and maintained participant engagement. Prior negative experiences and stigma/privacy concerns deterred trauma survivors from participating. CONCLUSIONS Peer support fulfills several functions throughout trauma survivors' recovery that may not otherwise be met within existing health care systems. Implications for rehabilitationBy understanding the functions and outcomes and the factors that impact implementation of peer support, evidence can be mobilized to enhance its application and uptake into standard practice.Peers provide trauma survivors with socioemotional support as well as assistance in daily management and life navigation post-injury.Peer support provided hope and guidance for the future after injury and improved self-efficacy amongst trauma survivors.Peer support programs are most likely to be successful when they involve knowledgeable peer mentors, are flexibly delivered, align with organizations' values and priorities, and have adequate resources and funding to support their implementation.
Collapse
Affiliation(s)
- Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Robert Simpson
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gotlib Conn
- Tory Trauma Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Collins KL, Linassi AG, Zucker-Levin A. A Focus Group- and Patient-Driven Study to Understand Patients' and Health Care Providers' Perspectives on Services for People with Amputation. Physiother Can 2021; 73:244-251. [PMID: 34456441 DOI: 10.3138/ptc-2019-0054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: This study investigates patients' and health care providers' perspectives on the services provided for people with amputation in Saskatoon. Method: We used a qualitative approach, following the Delphi method. A patient-oriented research team designed five questions and presented them to two focus groups. The discussions focused on what worked well in the health care system and what could be improved, what could be improved in the community, future research, and ways to improve specific knowledge translation regarding care of people with amputation to therapists. Results: The two focus groups consisted of 48 panellists, all community members and health care professionals. The themes that emerged included positive experiences with prosthetic care and the individual people responsible for amputee care and improvements needed to streamline the pathways of care, community support, education, and research into all aspects of amputation. Conclusions: Amputation is not just a one-time medical procedure; people with amputation need lifelong support from health care providers and the community. Clear pathways of care, access to immediate support, amputee-specific education for health care providers, better patient education, increased physical therapy, and enhanced resources and care were identified as areas in need of improvement. This study will, we hope, form the basis of future research to continually improve the quality of care and support for people living with amputation.
Collapse
Affiliation(s)
- Kassondra L Collins
- Health Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - A Gary Linassi
- Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Audrey Zucker-Levin
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
11
|
Layton N, Harper K, Martinez K, Berrick N, Naseri C. Co-creating an assistive technology peer-support community: learnings from AT Chat. Disabil Rehabil Assist Technol 2021:1-7. [PMID: 33977806 DOI: 10.1080/17483107.2021.1897694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Inclusion is a core philosophy for health practitioners and human service users, and co-production is a way to achieve inclusion. Australia's assistive technology (AT) community seeks to include and amplify the voices of service and product users at multiple levels. Implementation of genuine partnerships for inclusion is however challenging. This paper describes the iterative co-design process undertaken to structure and deliver a peer-led information and support program, enabling AT users and supporters to build their AT decision making capability and share their expertise with each other and the broader community. METHODS A living labs approach was grounded in co-design principles and drew on the peer education, AT competency and capability-building knowledge base. Methods included embedding intersectional capabilities within the service, and the engagement of over 600 people in design thinking and program iterations through surveys, focus groups, journey mapping and think tanks. RESULTS A national, peer-led, co-designed online community for AT users was established and has been running since 2017. The community of 5000 users contribute to a peer-led information and support initiative geared to share expertise and build AT decision making capability. CONCLUSIONS Service delivery by the AT user community and for the AT user community requires a commitment to co-design, and an engagement with concepts of risk, competency, scope of practice and capability. The learnings from AT Chat have implications for AT services on this journey everywhere.Implications for rehabilitationActive co-design of AT services meets human rights and good practice benchmarks required by contemporary services.Foregrounding AT users within program design and delivery, brings a range of positive outcomes and possibilities for the way services are delivered.AT users have substantial untapped potential which brings tangible outcomes for other AT users, health professionals, service provider organizations and for society.Development of paid roles and pathways to recognize the skills of AT users, and indeed AT communities has potential to improve AT user self-efficacy as well as to contribute to the AT workforce.
Collapse
Affiliation(s)
- Natasha Layton
- RAIL Research Centre, Monash University, Frankston, Australia.,Swinburne University of Technology, Hawthorn, Australia
| | - Kristy Harper
- Independent Living Assessment Incorporated, Perth, Australia
| | | | - Neil Berrick
- Independent Living Assessment Incorporated, Perth, Australia
| | - Chiara Naseri
- Independent Living Assessment Incorporated, Perth, Australia.,Curtin University School of Physiotherapy & Exercise Science, Bentley, Australia
| |
Collapse
|
12
|
Wu X, Hayter M, Lee AJ, Zhang Y. Nurses' experiences of the effects of mindfulness training: A narrative review and qualitative meta-synthesis. NURSE EDUCATION TODAY 2021; 100:104830. [PMID: 33684834 DOI: 10.1016/j.nedt.2021.104830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/18/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore nurses' experiences of the effects of undertaking mindfulness training. DESIGN Qualitative meta-synthesis. DATA SOURCES Qualitative literature from seven scientific databases: Pubmed, Cochran Library, Science Direct, EBSCO, Web of Science, Scopus and PsycINFO were searched. REVIEW METHODS The PRISMA flow diagram was used to report the phases of the literature search. The Critical Appraisal Skills Program (CASP) qualitative research checklist, and the Mixed-Methods Appraisal Tool (MMAT) for mixed method studies were used as appraisal framework. Data synthesis was conducted using Thematic synthesis. The review steps were guided by Adams, Chamberlain, & Giles, 2019 and Whittemore & Knafl, 2005. RESULTS 4 qualitative studies and 3 mixed-methods studies were included in the review. Four interpretive themes were generated to show how nurses experience of the effects of mindfulness training: 1. Stress conceptualisation and management; 2. Nurses' valued aspects of mindfulness training strategies; 3. Self-care awareness and strategies; 4. Challenges of mindfulness training. CONCLUSION Conducting mindfulness-based interventions among nursing professionals helps to reduce work-related stress and has positive effects on work and life.
Collapse
Affiliation(s)
- Xiaxin Wu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| | - Mark Hayter
- Faculty of Health Science, University of Hull, Cottingham Road, Hull, HU6 7RX Hull, UK.
| | - Amanda J Lee
- Faculty of Health Science, University of Hull, Cottingham Road, Hull, HU6 7RX Hull, UK
| | - Yu Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Yangzhou, China
| |
Collapse
|
13
|
Radenovic M, Aguilar K, Wyrough AB, Johnson CL, Luong S, Everall AC, Hitzig SL, Dilkas S, MacKay C, Guilcher SJT. Understanding transitions in care for people with major lower limb amputations from inpatient rehabilitation to home: a descriptive qualitative study. Disabil Rehabil 2021; 44:4211-4219. [PMID: 33599174 DOI: 10.1080/09638288.2021.1882009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To understand how people with major limb amputation experience the transition in care from inpatient rehabilitation to the community. METHOD A qualitative study was conducted using semi-structured interviews. Individuals were eligible if they had undergone a major lower limb amputation and had been discharged from inpatient rehabilitation to the community within one to twelve months. Interviews explored participants' experiences and factors associated with the transition in care. The interviews were audio-recorded, transcribed, and thematically analyzed. RESULTS Nine individuals with major lower limb amputation participated. Five themes were identified to describe the transition in care experience: (a) Preparedness: differing experiences during inpatient rehabilitation; (b) Challenges with everyday tasks: "everything has to be thought out"; (c) Importance of coping strategies; "gradually you accept it more and more" (d) Importance of support and feeling connected; "if I needed anything, they're right there" and (e) Not everyone has access to the same resources: "left to your own devices". CONCLUSIONS The identified themes concurrently influenced the transition from inpatient rehabilitation to the community. Common challenges during the initial transition were identified. Areas of improvement within inpatient rehabilitation included individualized care, discussions surrounding expectations, and better access to ongoing community support.Implication for rehabilitationTransition in care are difficult and vulnerable times for people with major lower limb amputation, especially when transitioning home following inpatient rehabilitation.Rehabilitation should prepare individuals for completing meaningful tasks in the home and community.Access to ongoing support in the community in the form of practical and emotional support can ease the challenges of transitioning home.
Collapse
Affiliation(s)
- Marija Radenovic
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Kamille Aguilar
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Anne B Wyrough
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Clara L Johnson
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Shirley Luong
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Amanda C Everall
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Steven Dilkas
- West Park Healthcare Centre, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.,West Park Healthcare Centre, Toronto, Canada
| |
Collapse
|
14
|
Keszler MS, Wright KS, Miranda A, Hopkins MS. Multidisciplinary Amputation Team Management of Individuals with Limb Loss. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00282-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
15
|
Benavent JV, Tenías JM, Pellin A, Casaña Mohedo J, Cabellos-García AC, Gea-Caballero V. Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082691. [PMID: 32295274 PMCID: PMC7216231 DOI: 10.3390/ijerph17082691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/19/2020] [Accepted: 04/07/2020] [Indexed: 11/16/2022]
Abstract
Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in “appearance” and “perception of appearance” (significantly higher levels for men). Older patients tended to have worse scores in “utility”, “frustration”, “social burden” and “deambulation”. More favorable scores were obtained for those residing in rural areas in “social burden” and “deambulation”. Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.
Collapse
Affiliation(s)
| | - José María Tenías
- Dirección General de Investigación, Innovación, Tecnología y Calidad, Conselleria de Sanitat Universal i Salut Pública, 46010 Valencia, Spain;
| | - Ana Pellin
- Valencia International University, 46002 Valencia, Spain;
| | - Jorge Casaña Mohedo
- Universidad Europea, 46010 Valencia, Spain
- Correspondence: (J.C.M.); (A.C.C.-G.); Tel.: +34-670-634-579 (J.C.M.)
| | - Ana Cristina Cabellos-García
- Hospital Universitari i Politècnic La Fe, Grupo de Investigaciόn Enfermero en Arte y Ciencia del Cuidado GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain
- Correspondence: (J.C.M.); (A.C.C.-G.); Tel.: +34-670-634-579 (J.C.M.)
| | - Vicente Gea-Caballero
- Nursing School La Fe, Adscript Center of Universitat de Valencia, Grupo de Investigaciόn en Arte y Ciencia del Cuidado GREIACC, Health Research Institute La Fe, 46026 Valencia, Spain;
| |
Collapse
|
16
|
|
17
|
Nathan EP, Winkler SL. Amputees' Attitudes Toward Participation in Amputee Support Groups and the Role of Virtual Technology in Supporting Amputees: Survey Study. JMIR Rehabil Assist Technol 2019; 6:14887. [PMID: 31469085 PMCID: PMC6777423 DOI: 10.2196/14887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/18/2019] [Accepted: 08/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acquiring information about and living with an amputation (or limb differential) is a lifelong endeavor. Although medical institutions address the immediate medical needs of amputees, information regarding how to live life as an amputee is provided from numerous sources, one of which is amputee support groups. OBJECTIVE This study aimed at understanding why amputees join support groups, leave support groups, and possibly return to support groups as well as how technology, specifically virtual reality, might play a role in supporting patients' needs. The results are intended to provide data for support groups, to increase their impact on amputee participants. METHODS A 38-item online survey was developed based on the findings of a previous randomized trial. The survey was administered between April and September 2018 and divided into four sections: Demographics, Limb Loss History, Amputee Support Group Participation, and Technology Usage. Items used multiple-choice, drop-down menu, check-box formats with explanation boxes for open-ended responses. Descriptive analyses were performed for both qualitative (open-ended questions) and quantitative data. RESULTS Of the 59 amputees enrolled, 54 completed the survey. All the respondents were aged 20-39 years, and nearly half of the older respondents thought audio and video teleconferencing or avatar-based technology would increase participation in support groups. The results suggest that an early goal for amputees who join support groups is to focus on regaining mobility and functionality in order to return to their normal life. Once achieved, the goal transitions to one of social connection with other amputees, although there is a caveat: Simply being an amputee may not provide sufficient connections for developing long-term social relationships. The strongest reason for joining a support group was to learn about living with an amputation, followed by networking and learning new skills. CONCLUSIONS The results suggest four key takeaways regarding amputee participation in support groups: (1) the needs of participants in amputee support groups change over time; (2) meeting content needs to be relevant to agendas primarily driven by participants; (3) support group participation is also driven by the desire to increase functionality by developing skills, become familiar with prosthetic technology, have more than amputation in common with other participants, and participate at the designated meeting time and location; and (4) the use of technology should support patients' needs.
Collapse
Affiliation(s)
- Edward P Nathan
- Roy H Park School of Communications, Ithaca College, Ithaca, NY, United States
| | - Sandra L Winkler
- Research Service, James A Haley Veterans Affairs Hospital, Tampa, FL, United States.,Occupational Therapy Department, Nova Southeastern University, Fort Lauderdale, FL, United States
| |
Collapse
|
18
|
Lindner H, Montgomery S, Hiyoshi A. Risk of depression following traumatic limb amputation—a general population-based cohort study. Scand J Public Health 2019; 48:289-293. [DOI: 10.1177/1403494819868038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Individuals with traumatic limb amputation (TLA) may be at risk of depression, but evidence of increased depression after TLA from longitudinal studies has been limited. It is also unknown whether physical function, cognitive function, and employment prior to amputation affects depression risk. We aimed to examine longitudinal associations between TLA and depression in working age men, and to explore the role of pre-amputation occupational and individual characteristics. Methods: A Swedish national register-based cohort of 189,220 men born between 1952 and 1956, and who attended conscription assessments in adolescence, was followed from 1985 to 2009. Physical, cognitive, and psychological characteristics were measured at the conscription examination, and occupational information was obtained from the 1985 census. Main outcome measures were hospital inpatient and outpatient admissions for depression. Results: In total, 401 men underwent TLA; mean age at amputation was 42.5 years (SD 7.4). Cox regression produced an unadjusted hazard ratio (95% confidence interval) of 2.61 (1.62–4.21) for risk of subsequent depression associated with TLA compared with the general population. Adjustment for occupational, physical, cognitive, and psychological characteristics did not change the association much, producing a hazard ratio of 2.53 (1.57–4.08). Conclusions: TLA is associated with an increased risk of depression in men over more than two decades of follow up. Occupational and individual characteristics prior to amputation did not greatly change depression risk following amputation. We speculate that a coordinated combination of social support and medical management may help reduce persistent depression risk in men who experience amputation.
Collapse
Affiliation(s)
- Helen Lindner
- Institution for Health Sciences, Örebro University, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Sweden
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, UK
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Sweden
- Department of Public Health Sciences, Stockholm University, Sweden
| |
Collapse
|
19
|
Richardson LJ, Molyneaux V, Murray CD. Being a peer support mentor for individuals who have had a lower limb amputation: an interpretative phenomenological analysis. Disabil Rehabil 2019; 42:3850-3857. [DOI: 10.1080/09638288.2019.1611954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Craig D. Murray
- Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| |
Collapse
|
20
|
Abstract
: The Trauma Survivors Network (TSN) was developed as a program of the American Trauma Society (ATS) to support recovery for adult trauma patients. However, the children of adult trauma patients, families of pediatric trauma patients, and pediatric trauma patients previously had scarce resources. Our institution, in collaboration with the ATS, sought to expand the TSN to support pediatric trauma patients, caregivers, and family members. We aimed to determine whether the TSN could be transferred to the pediatric population. Focus groups identified psychosocial needs of younger survivors, children of adult survivors, and caregivers. A Pediatric TSN Coordinator was hired, Pediatric TSN Peer Visitors were recruited and trained, and Pediatric TSN Activity Hour was implemented for pediatric patients and families. Since implementation 1 year ago, 26 peer visitors have been trained and have conducted approximately 200 visitations. In total, 93 patients and family members have attended Pediatric TSN Activity Hour. TSN services can be adapted to address psychosocial needs of pediatric trauma survivors, families, and children of trauma survivors. When possible, sharing resources between an existing adult TSN program and a pediatric program is valuable to facilitate expansion. TSN complements and strengthens the care offered at our institution by providing patient-centered and family-centered care services for the entire family at various stages of development. The implementation of this program might be different at sites without an existing adult TSN with established resources and support. This article describes the development and implementation of the program; we did not assess outcomes.
Collapse
|
21
|
Sturgeon-Clegg I, Hurn H, McCauley M. Neuropsychology and clinical health psychology in the UK Ministry of Defence. J ROY ARMY MED CORPS 2018; 165:87-89. [PMID: 30415217 DOI: 10.1136/jramc-2018-001049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/16/2018] [Indexed: 11/03/2022]
Abstract
Neuropsychological testing has been used in a wide range of applications across military settings, including the selection of personnel to engage in covert operations, battlefield assessment and rehabilitation following blast exposure, traumatic brain injury, other neurological conditions and assessment of malingering. Over recent decades, military psychologists have helped to shape the advances in assessing and remediating the psychological sequela that is associated with operationally related neurological and other physical injuries. This paper will present an overview of some of the neuropsychological and related services within the UK Armed Forces, which are provided to service personnel with traumatic brain and other physical injuries.
Collapse
Affiliation(s)
| | - H Hurn
- Defence Clinical Psychology Service, Ministry of Defence, London, UK
| | - M McCauley
- Defence Clinical Psychology Service, Ministry of Defence, UK & School of Psychology, Trinity College, University of Dublin, Dublin, Ireland
| |
Collapse
|