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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.
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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
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Nugent K, Joshi A, Viana R, Payne MW, Unger J, Hunter SW. How has body image been evaluated among people with lower limb loss? A scoping review. Disabil Rehabil 2024:1-14. [PMID: 38563712 DOI: 10.1080/09638288.2024.2335646] [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: 07/25/2023] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Lower limb loss can result in an altered body image, leading to changes in self-esteem, mental health and quality of life. This scoping review explored how body image has been evaluated among people with lower limb loss. MATERIALS AND METHODS Five databases (Embase, Medline, PsychINFO, CINHAL, and Nursing and Allied Health Database) were searched from inception until March 19, 2023. Inclusion criteria: 1) people with lower limb loss; 2) evaluated a body image outcome or theme; and 3) a qualitative, quantitative or mixed methods design. RESULTS Twenty-four quantitative (n = 19 cross-sectional, n = 3 intervention cohort and n = 2 prospective cohort), 2 qualitative and 1 mixed methods design studies were included. The definition of body image varied across studies, with 59% of studies not reporting a conceptual or theoretical definition. People with lower limb loss perceived a more negative body image compared to control groups. In prospective cohort studies, changes in body image over time were inconclusive. CONCLUSION People with lower limb loss report a negative body image when compared to other populations. Definitions and understanding of body image changed overtime and varied among studies which may impact introducing interventions to promote positive body image during rehabilitation and beyond in this population.
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Affiliation(s)
- Kristin Nugent
- Faculty of Health Sciences, Western University, London, Canada
- School of Physical Therapy, Western University, London, Canada
| | - Atharv Joshi
- Faculty of Health Sciences, Western University, London, Canada
| | - Ricardo Viana
- Department of Physical Medicine and Rehabilitation, Parkwood Institute, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Michael W Payne
- Department of Physical Medicine and Rehabilitation, Parkwood Institute, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Janelle Unger
- Faculty of Health Sciences, Western University, London, Canada
- School of Physical Therapy, Western University, London, Canada
- The Gray Centre for Mobility and Activity, Parkwood Institute, London, Canada
| | - Susan W Hunter
- Faculty of Health Sciences, Western University, London, Canada
- School of Physical Therapy, Western University, London, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Canada
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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.
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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
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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.
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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
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Chao N, Som M, Workneh E, Karwoski A, Dunlap E, Fitzpatrick S, Nagarsheth K. Comparison of Pre-existing Mood Disorders and Chronic Kidney Disease as Predictors of Ambulatory Status After Major Limb Amputation. Cureus 2023; 15:e39215. [PMID: 37337488 PMCID: PMC10276894 DOI: 10.7759/cureus.39215] [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] [Accepted: 05/19/2023] [Indexed: 06/21/2023] Open
Abstract
Objective We aim to compare the effects of pre-existing mood disorders and chronic kidney disease (CKD) on ambulation outcomes for patients who have undergone major lower extremity amputation (MLEA) while also stratifying by the presence of social factors. Methods We performed a retrospective chart review of 700 patients admitted from 2014 to 2022 who underwent MLEA. We performed Chi-square tests and binomial logistic regression with p < 0.05 as our significance level. Results Mood disorder patients have higher rates of independent ambulation if they have familial support (p = 0.022), a listed primary care provider (PCP; p = 0.013), a six-month follow-up (p < 0.001), or a one-year follow-up (p < 0.001). Patients with a history of mood disorder have significantly decreased odds of prosthesis usage (OR: 0.58, 95% CI: 0.40-0.86) but have higher rates of prosthesis usage if they have familial support (p = 0.002), a PCP listed (p = 0.005), a six-month follow-up (p < 0.001), or a one-year follow-up (p < 0.001). CKD patients have significantly decreased odds of eventual independent ambulation (OR: 0.69, 95% CI: 0.49-0.97) but have significantly increased rates of independent ambulation if they have familial support (p =0.041) and six-month (p < 0.001) or one-year follow-up (p < 0.001). CKD patients only have significant changes in prosthesis usage with a six-month (p < 0.001) or one-year follow-up (p < 0.001). Conclusions Pre-existing CKD and mood disorders are associated with decreased odds of independent ambulation and prosthesis usage, respectively. Social factors such as family support, a listed PCP, and timely follow-up are associated with markedly improved ambulatory outcomes for MLEA patients with mood disorders and CKD, with significantly improved prosthesis usage outcomes in only the mood disorder population.
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Affiliation(s)
- Natalie Chao
- Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Maria Som
- Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Eyerusalem Workneh
- Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Allison Karwoski
- Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA
| | - Eleanor Dunlap
- Vascular Surgery, University of Maryland Medical Center, Baltimore, USA
| | | | - Khanjan Nagarsheth
- Vascular Surgery, University of Maryland School of Medicine, Baltimore, USA
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Multidisciplinary Team-based Amputee Care: Level Sparing Surgical Techniques and Treatment of Chronic Pain. Tech Orthop 2021. [DOI: 10.1097/bto.0000000000000561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hewitt MA, Smith DG, Heckman JT, Pasquina PF. COVID-19: A catalyst for change in virtual health care utilization for persons with limb loss. PM R 2021; 13:637-646. [PMID: 33866685 PMCID: PMC8250996 DOI: 10.1002/pmrj.12605] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/24/2021] [Accepted: 04/05/2021] [Indexed: 12/16/2022]
Abstract
The dramatic uptake of virtual care, or telehealth, utilization because of COVID‐19 restrictions for persons with limb loss has led to a much greater understanding of this health care delivery method for this complex patient population. However, much is still unknown. Therefore, the authors provide a comprehensive literature review of existing evidence for virtual care delivery across the phases of amputation rehabilitation, as well as anecdotal evidence, to provide a platform for further discussion and development of research and innovative opportunities. Evidence reveals that virtual care serves as a complement to in‐person health care for individuals with limb loss because it allows for increased accessibility to these services. The authors conclude that continued use of telehealth beyond the COVID‐19 restrictions to optimize outcomes across the continuum of care for persons with limb loss is warranted.
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Affiliation(s)
- Melissa A Hewitt
- The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.,Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Douglas G Smith
- The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.,Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Jeffrey T Heckman
- James A. Haley VA Medical Center, Tampa, Florida, USA.,Physical Medicine and Rehabilitation, University of South Florida, Tampa, Florida, USA
| | - Paul F Pasquina
- The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.,Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Puthenpura V, Marks AM. Clinical Application of Digital Technologies in Adolescent and Young Adult Oncology Supportive Care. J Adolesc Young Adult Oncol 2020; 10:127-130. [PMID: 33296259 DOI: 10.1089/jayao.2020.0153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Vidya Puthenpura
- Section of Pediatric Hematology and Oncology, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Asher M Marks
- Section of Pediatric Hematology and Oncology, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
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Subrata SA. Implementation of spiritual care in patients with diabetic foot ulcers: a literature review. ACTA ACUST UNITED AC 2020; 29:S24-S32. [PMID: 32790549 DOI: 10.12968/bjon.2020.29.15.s24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Lower extremity amputation is a complication of diabetic foot ulcers that can cause spiritual crisis. Integrating spiritual care into nursing practice is important to overcome this. However, studies articulating the role of nurses in spiritual care when caring for patients with diabetic foot ulcers is limited. This article aims to describe the importance of providing spiritual care for this group of patients. The interpretation of spiritual care with respect to the relationship between the patient and the family, and the role of the nurse are discussed. The findings offer a theoretical perspective on spiritual care that can be used to develop spiritual interventions, as well as prevent spiritual crises in patients with diabetic foot ulcers.
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Affiliation(s)
- Sumarno Adi Subrata
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand, Nursing Lecturer at the Department of Nursing and Wound Research Centre, Faculty of Health Sciences, Universitas Muhammadiyah Magelang, Indonesia
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