Taxonomy of clinical encounters during the first 90 days post-delivery of an initial lower limb prosthesis

The experience of self-managing from the perspective of persons with lower limb loss, prosthetists, and physical therapists

PURPOSE

Persons with lower limb loss (PwLLL) must self-manage their residual limb and their prosthesis to prevent self-management related complications (SMRC). However, the experience of PwLLL as it relates to self-management has not been reported. Thus, the purpose of this study was to explore the experience of self-management from the perspective of PwLLL, prosthetists, and physical therapists.

METHODS

This study had a qualitative design. Twenty-three participants were interviewed (PwLLL = 10, prosthetists = 7, physical therapists = 6). Interviews were transcribed and then coded using constant comparison.

RESULTS

Four prominent themes were developed from the transcripts: (1) embodying the duty of self-management, (2) being a vigilant self-advocate, (3) setting goals collaboratively, and (4) making informed decisions. Each of the four themes were influenced by the health beliefs of the PwLLL, specifically motivation and presence of an internal locus of control.

CONCLUSION

Clinicians should emphasize the therapeutic relationship, including open communication, collaborative goal setting, and promoting an internal locus of control in interactions with PwLLL, as it may play a role in decreasing SMRC and improving clinical outcomes.Implications for rehabilitationSelf-management is a crucial aspect of preventing secondary complications associated with limb loss and prosthesis use.Self-management requires an internal locus of control, problem-solving abilities, and foundational knowledgeClinicians can promote self-management through collaborative goal setting and systematic education.