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A Longitudinal Study of Social Participation After Dysvascular Lower Extremity Amputation
Ann Marie Roepke1, Rhonda M Williams, Aaron P Turner
1From the VA Puget Sound Health Care System, Rehabilitation Care Service, Seattle, Washington (AMR, RMW, APT, AWH, KNH, JMC); University of Washington, Department of Rehabilitation Medicine, Seattle, Washington (RMW, APT, KNH, JMC); Spectrum Research, Inc, Tacoma, Washington (DCN); and Houston VA Medical Center, Physical Medicine and Rehabilitation, Houston, Texas (HH).
Objective:
This study examined patterns of social participation among individuals experiencing their first dysvascular lower extremity amputation. We identified the types of social participation valued by this population and explored factors that were associated with individuals' levels of participation and their subjective satisfaction with participation.
Design:
A prospective cohort was recruited from four Veterans Administration Medical Centers and followed for 1 yr after amputation. Social participation was measured with a modified version of the Community Integration Questionnaire. Potential correlates included the Patient Health Questionnaire-9, Modified Social Support Survey, Locomotor Capability Index 5, Short Portable Mental Status Questionnaire, and self-rated health.
Results:
At 1-yr postamputation, participants indicated that the most valued aspects of social participation were maintaining close friendships, visiting loved ones, and managing finances. Levels of social participation and satisfaction with participation were modest at 1-yr postamputation. Higher levels of social participation at 1 yr were related to better baseline mental status, better premorbid mobility, and lower amputation level. Higher satisfaction with participation was related to greater baseline social support.
Conclusions:
Individuals' social participation may be influenced by physical and cognitive factors, whereas their satisfaction with participation may be influenced by psychosocial factors. Rehabilitation specialists are encouraged to address both aspects of social participation when formulating and pursuing rehabilitation goals.