The influence of environment

Abstract

Background:Prostheses are used to varying degrees; however, little is known about how environmental aspects influence this use.Objectives:To describe users’ experiences of how environmental factors influence their use of a myoelectric arm prosthesis.Study design:Qualitative and descriptive.Methods:A total of 13 patients previously provided with a myoelectric prosthetic hand participated. Their age, sex, deficiency level, etiology, current prosthesis use, and experience varied. Semi-structured interviews were audiotaped, transcribed, and analyzed through inductive content analysis.Results:Four categories were created from the data: “Prosthesis function,” “Other people’s attitudes,” “Support from family and healthcare,” and “Individual’s attitude and strategies.” The overarching theme, “Various degrees of embodiment lead to different experiences of environmental barriers and facilitators,” emerged from differences in individual responses depending on whether the individual was a daily or a non-daily prosthesis user. Environmental facilitators such as support from family and healthcare and good function and fit of the prosthesis seemed to help the embodiment of the prosthesis, leading to daily use. This embodiment seemed to reduce the influence of environmental barriers, for example, climate, attitudes, and technical shortcomings.Conclusion:Embodiment of prostheses seems to reduce the impact of environmental barriers. Support and training may facilitate the embodiment of myoelectric prosthesis use.Clinical relevanceFor successful prosthetic rehabilitation, environmental factors such as support and information to the patient and their social network about the benefits of prosthesis use are important. Local access to training in myoelectric control gives more people the opportunity to adapt to prosthesis use and experience less environmental barriers.

Environmental barriers to participation and facilitators for use of three types of assistive technology devices

“…Prosthesis use is greatly affected by the environment, and qualitative research implies that the experience from environmental influence differs depending on how much the MEP is used; daily prosthesis users experience more support and less environmental barriers [2]. To strengthen this conclusion and also to investigate if it is valid for other types of advanced assistive technology (AT), a further study based on quantitative methodology is needed.…”

Obstacles to Prosthetic Care—Legal and Ethical Aspects of Access to Upper and Lower Limb Prosthetics in Germany and the Improvement of Prosthetic Care from a Social Perspective

“…The acceptability of assistive technology is dependent not only on its efficiency, but also on the reactions it elicits in people surrounding the user, as people with limb loss themselves have rated social outcomes as more important for assessing quality of life outcomes than their physical impairment [11,12]. Good social support has been identified as a predictor for not only the perceived quality of life, but also the functional outcome after amputation [13,14].…”

“…Psychosocial adjustment is defined as an individual's response to events having a significant impact on their lives, which require adaptation. Influential factors on positive psychosocial adaptation have not been explored widely [20], despite the fact that it seems like this adaptation is one of the most powerful facilitators of later prosthesis use and a high quality of life [12,20,21]. There is, however, some evidence that factors such as an active coping style, as well as general (dispositional) optimism, a tendency for "downwards social comparison", as well as the feeling that one has some control over one's own situation, are all favourable indicators for good psychosocial adjustment [15,22].…”

Body‐Self Unity With a New Hip or Knee: Understanding Total Joint Replacement Within an Embodiment Framework

“…The literature on prosthetic limbs provides other models . But, as with the transplant literature, the experience of TJR ultimately diverges.…”