Multidisciplinary Amputation Team Management of Individuals with Limb Loss

Keszler, Mary S.; Wright, Katherine S.; Miranda, Alberto; Hopkins, Mark R.

doi:10.1007/s40141-020-00282-4

Cited by 16 publications

(12 citation statements)

References 56 publications

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“…With this evaluation, the needs and goals of each person, the resources they have and their greatest source of vulnerability could be individually assessed, in order to adapt health resources in a personalized way and improve adaptation to the new life situation after amputation. In fact, Keszler et al (2020) defends the utility of having a multidisciplinary team that cares for people who will undergo amputation of the lower limbs throughout the process. The pre-amputation evaluation is one of the key phases of the intervention and should consider all aspects related to amputation, not only physical and medical: psychosocial and functional factors are also essential to improve the results obtained in the short, medium, and long term.…”

Section: Discussionmentioning

confidence: 99%

Early Patient Experiences of Primary Above-the-Knee Amputation From Vascular Etiologies: A Phenomenological Study

et al. 2020

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The aim of this study was to explore the different meanings of the experience of lower-limb amputation due to vascular causes in the time period from the fifth to twelfth week post-amputation. A phenomenological study involving semi-structured interviews was carried out. Data collection took place in a Public Hospital in Spain and included a convenience sample of 20 patients who had undergone amputation. The study highlighted patients’ fears related to mobility, pain, dependence, and autonomy. Moreover, patients experience of the rehabilitation process and resources for adaptation were described as well as all the changes related to the social environment. The figure of a nurse was considered essential after amputation by the patients. This study provides a deep understanding of their experiences at the immediate time after amputation considering patients demographical associations and the etiology of the vascular pathology. This could be the starting point to understand patients’ immediate needs upon discharge.

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Section: Discussionmentioning

confidence: 99%

Early Patient Experiences of Primary Above-the-Knee Amputation From Vascular Etiologies: A Phenomenological Study

et al. 2020

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“…The participants were selected from a list of formerly admitted patients at the rehabilitation unit. Inclusion criteria were transfemoral amputation of at least three years, because transfemoral amputation is associated with poorer physical functioning compared to transtibial amputation [ 2 , 7 ]. The criterion of at least three years post amputation was chosen in order for the participants having made their own experiences over a significant amount of time [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…This is a complex process, which includes recovering from the surgery into ambulating with a prosthesis. Major stages in the rehabilitation process can include healing of the residual limb, prevention of complications, and promotion of functional independence [ 7 ], with a lifelong perspective. The process requires a highly specialised multidisciplinary team [ 3 , 7 , 8 ], which preferably take a holistic approach.…”

Section: Introductionmentioning

confidence: 99%

“…Major stages in the rehabilitation process can include healing of the residual limb, prevention of complications, and promotion of functional independence [ 7 ], with a lifelong perspective. The process requires a highly specialised multidisciplinary team [ 3 , 7 , 8 ], which preferably take a holistic approach. The purpose of rehabilitation is to optimise health, function, independence, and quality of life [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Facilitators and Barriers That Transfemoral Amputees Experience in Their Everyday Life: A Norwegian Qualitative Study

Sørensen

Berg

2022

Rehabilitation Research and Practice

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Background. Living with a lower limb amputation influences multiple facets of life due to altered function. Individuals achieve a varied level of function post amputation, depending on several variables like age, level of function prior to amputation, and available personal and environmental resources. Releasing the potential to live life to the fullest despite a disability is important to the individual. Objectives. The primary objective of this study is to identify barriers and facilitators for function which lower limb amputees experience in their lives several years after amputation, from the amputee’s perspective. This knowledge can contribute to further development of the clinical pathway for lower limb amputees in a Norwegian rehabilitation hospital. Methods. The study has a descriptive and exploratory qualitative design with a phenomenological hermeneutical approach. Semistructured, individual interviews were conducted for data collection. Thematic analysis inspired by Braun and Clarke was used for data analysis. The sample consisted of eight transfemoral amputees ( 70 ± 6.9 (58-77 years)) living in the southern part of Norway. Average time since amputation was 11 years. Results. The results have been categorised into two main themes with subthemes: (1) facilitators: personal resources, a well-fitted prosthesis, rehabilitation, social network, balance in activity/rest, and accessibility and (2) barriers: walking distance, poorly fitted prosthesis, pain, comorbidities, climate/terrain/falling, reduced local competence on amputation, and pandemic. Conclusion. Lower limb amputees experience barriers in their everyday life, but they also develop strategies to cope with their disability. Clinical implications can include increased nutritional guidance, structural psychological mapping and follow-up, structured follow-ups over a significant period of time, and extended use of digital consultation.

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“…Each stage of postamputation adaptation requires different aspects to be attended to and managed based on the needs and limitations of the patients. A multidisciplinary approach centered on patients and their caregivers is ideal for comprehensive rehabilitation and biopsychosocial management [ 42 ]. Psychological interventions should be performed as early as possible to minimize psychological distress during amputation.…”

Section: Considerations and Psychological Intervention By Periodmentioning

confidence: 99%

Psychiatric understanding and treatment of patients with amputations

Kang

Seo

et al. 2021

Yeungnam Univ J Med

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Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient's adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

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Multidisciplinary Amputation Team Management of Individuals with Limb Loss

Cited by 16 publications

References 56 publications

Early Patient Experiences of Primary Above-the-Knee Amputation From Vascular Etiologies: A Phenomenological Study

Early Patient Experiences of Primary Above-the-Knee Amputation From Vascular Etiologies: A Phenomenological Study

Facilitators and Barriers That Transfemoral Amputees Experience in Their Everyday Life: A Norwegian Qualitative Study

Psychiatric understanding and treatment of patients with amputations

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