An integrative review of peer support for patients undergoing major limb amputation

Medical literature is replete with evidence regarding physical rehabilitation of the amputee; however, scant attention has been paid to psychological rehabilitation. The objective was to perform an integrative review of the published medical evidence regarding amputee peer support in the civilian population and provide an evidence-based clinical practice recommendation. This study was based on an exhaustive examination of the civilian amputee peer support medical evidence, bibliographic search, and on the experience of the authors when performing this integrative review. Our search uncovered 10 published peer-reviewed pieces of medical evidence including one level III retrospective case controlled trial, two level IV case series, and seven level V expert opinions. Given the totality of the published evidence, albeit limited, in favor of amputee peer support, an abundance of unpublished anecdotal evidence, virtually no potential risk of harm, and low cost, it seems reasonable to recommend incorporating a preoperative and/or postoperative peer visit in clinical protocols for all patients incurring a major limb amputation.