Positive Coping and Stress-Related Psychological Growth Following Lower Limb Amputation.

Abstract

To present a cross-sectional qualitative exploration of how individuals cope with a lower limb amputation and to examine the influence of positive coping and stress-related psychological growth on adjustment. Participants: 12 patients with a lower limb amputation. Setting: Artificial Limb and Appliance Centre in South Wales, United Kingdom. Design: Semistructured interviews, using grounded theory for analysis. Measures: The Hospital Anxiety and Depression Scale (A. Zigmond & R. Snaith, 1983) and the Rosenberg Self-Esteem Scale (M. Rosenberg, 1965). Results: No evidence of psychological distress among participants. Qualitative analysis revealed 5 categories of coping, and a theoretical model of positive coping following lower limb amputation was generated. Conclusions: Coping strategies evolve, reflecting the changes in psychological demands postamputation. Positive coping and psychological growth facilitates psychological adjustment. Clinicians may facilitate adaptive outcomes by appreciating the positive psychology perspective.

Expectations of rehabilitation following lower limb amputation: a qualitative study

“…This determined attitude has been described in other studies; for example, Oaksford et al [23] noted that patients needed to feel a sense of control over their situation and often dealt with the traumatic event of an amputation by trying to look towards the future in a positive way. The implications of not maintaining this attitude may be added to the adjustment concerns faced by the new amputee.…”

“…This is supported by a number of studies. Oaksford et al [23] suggested that established amputees are seen as credible informants and that access to them should be a standard part of rehabilitation. Gallagher and MacLachlan [22] suggest amputees may act as positive role models helping patients who are new amputees, to believe they could achieve the same things.…”

“…However, this process can only be managed successfully if discussed with others and support is given to enable patients to respond creatively to their new situation, as well as to encourage them to keep trying to overcome the challenges they face. Oaksford et al [23] suggest that, for amputees, actively aiming to solve the challenges they face is an important coping strategy and is often linked to positive adjustment. Discussing and realistically working through these contradictions as they arise throughout the rehabilitation process may help patients to develop this problem solving approach and aid the acceptance of their new normal.…”

“…This can be overcome by using the prosthesis to conceal the disability and allow the amputee to control when and to whom they disclose the information. Oaksford et al [23] highlighted that patients can feel very socially isolated after an amputation and that even just one negative social interaction can have serious emotional and behavioural consequences. Supporting amputees through this process, in terms of addressing the actual and perceived social stigmas of their new disability, should also be considered as part of the rehabilitation process [10].…”

Coping with a Lower Limb Amputation due to Vascular Disease in the Hospital, Rehabilitation, and Home Setting

“…This may be because most studies used questionnaires and very few are based on an inductive process to uncover coping strategies specific to lower limb amputations. In a grounded theory proposed by Oaksford et al [30], humor was identified as a coping strategy to deal with disability within the first 6 months, one year, and five years following transtibial amputation. On the other hand, Rybarczyk, Nicholas, and Nyenhuis [31] conceptualized humor as a tool that facilitates coping but not as a coping strategy.…”