War, amputation, and resilience: assessing health-related quality of life in Syrian prosthetic users

Lower limb amputation has a significant impact on an individual's overall quality of life, with prosthetic devices serving as essential tools for rehabilitation and mobility restoration. In Syria, where access to advanced medical care remains constrained, identifying the key factors affecting the well-being of prosthesis users is crucial for enhancing rehabilitation strategies. This study examines the sociodemographic and health-related determinants influencing the quality of life among lower-limb amputees who rely on prosthetic devices in Syria.

This research employed a cross-sectional design at a highly specialized disability care facility within a tertiary hospital. A total of 233 individuals with lower limb amputations, all of whom had been using prosthetic limbs for at least five years, participated in the study. The sample was drawn from patients receiving treatment at the same medical institution. Data collection encompassed sociodemographic details, health status, and pain-related experiences. The SF-12 questionnaire was utilized to assess health-related quality of life (HrQoL), categorizing scores above 50 as indicative of good HrQoL in both the Mental Component Summary (MCS) and Physical Component Summary (PCS), while scores below 50 denoted poor HrQoL. Statistical analysis involved the Chi-square (χ²) test, applied with a 95% confidence level to examine associations among the study variables.

The study assessed health-related quality of life among individuals with lower limb amputations, indicating that 62.23% had high mental health scores, while 66.09% demonstrated high physical health scores. Analysis revealed significant links between age and marital status with both the MCS and PCS. Furthermore, the cause of amputation and the occurrence of phantom pain were associated with MCS. Several pain-related factors, including residual limb pain treatment, its perceived effectiveness, and residual residual limb pain, showed significant associations with both MCS and PCS. Additionally, extremity dominance and actions taken to manage residual limb pain were notably linked to PCS. Lastly, a significant relationship was observed between the level of amputation and the treatment of phantom pain.

These findings emphasize the significant impact of age, marital status, limb dominance, cause of amputation, and residual limb pain treatment on the quality of life of lower limb amputees. They highlight the need for comprehensive rehabilitation programs that prioritize effective pain management, social support, and personalized care tailored to the unique demographic and clinical needs of each individual.