Living with limb loss: individuals' and prosthetists' perceptions of amputation, prosthesis use and rehabilita

Abstract

Loss of limb through amputation presents a significant, life changing, circumstance for individuals. The prosthetist as the gate keeper to the health-care system and the facilitator of rehabilitation is essential to positive adjustment post-amputation. As yet, however, commonalities and differences in the understandings of each of these parties of the experience of limb loss, prosthesis use and rehabilitation remain unexamined. This comparison provides the focus for this study. Fifteen individuals post amputation and 13 prosthetists were interviewed on their perceptions of limb loss and prosthesis use. Semi structured interviews were conducted, face to face, via telephone or via email. Data were audio-recorded and transcribed as necessary and thereafter analysed using Interpretative Phenomenological Analysis (IPA) in order to gain an understanding of the subjective experiences of individuals with limb loss and of prosthetists of the post-amputation process. Analysis of the data led to identification of four key themes, namely Personal Identity, Social Identity, The Prosthesis and Communication. These themes were relevant for both groups. The meanings that they held for the two groups, however, differed in relation to key elements of the post-amputation experience. Both groups have a shared interest in the process of prosthetic limb fitting and rehabilitation and yet come from very differing perspectives. The fitting and use of a prosthetic device is not a simple, technical process but rather involves a combination of psychological, social and practical components all of which must be recognized in the rehabilitation process. The differing expectations and understandings held by both groups become especially evident in interactions between individuals with limb loss and prosthetists. Communications between members of these groups can provide a central point for addressing differences in their understandings of living with limb loss and might provide a focus for further developments in research and practice.