A Psychosocial Adjustment Measure for Persons With Upper Limb Amputation

Area of Science:

• Rehabilitation Psychology
• Clinical Psychology
• Health Psychology

Background:

• Psychosocial adjustment measurement after upper limb amputation (ULA) is crucial for identifying individuals needing interventions.
• Existing measures are limited to prosthetic users, excluding a significant patient population.

Purpose of the Study:

• To develop a novel measure of psychosocial adjustment for individuals with ULA, applicable irrespective of prosthesis use.
• To create a psychometrically sound tool for assessing adjustment challenges in amputees.

Main Methods:

• Modified existing survey items and created new ones for non-prosthetic users.
• Conducted cognitive interviewing and pilot testing for item refinement.
• Administered a telephone survey to 727 individuals with major ULA, followed by factor and Rasch analyses.

Main Results:

• Exploratory and confirmatory factor analyses revealed a two-factor structure.
• Rasch analyses supported a 7-item Adjustment to Limitation subscale and a 9-item Work and Independence subscale.
• The measure demonstrated good reliability (Cronbach's alpha: 0.82-0.90) and moderate to good test-retest reliability (ICC: 0.63-0.80).

Conclusions:

• The Psychosocial Adjustment to Amputation (PAA) measure was successfully developed.
• The PAA measure exhibits sound structural validity and reliable scoring.
• This new tool provides a comprehensive assessment for diverse ULA populations, facilitating targeted support.