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Published on: December 11, 2013
Psychosocial Perspectives Following Lower Limb Amputation Due to Vascular Etiology: A Systematic Meta-Aggregation
Iben Engelbrecht Giese1, Tanja Mortensen Chræmmer2, Helle Lund Rasmussen2
1Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Purpose:
Major dysvascular lower limb amputations often lead to psychosocial challenges postdischarge. This review aimed to synthesize evidence on the psychosocial perspectives during the postdischarge rehabilitation phase.
Design:
Systematic meta-aggregation.
Methods:
Full-text peer-reviewed articles were retrieved from PubMed, Embase, APA PsycInfo, Scopus, and CINAHL Ultimate up to August 11, 2023. Data were synthesized using the Joanna Briggs Institute meta-aggregation approach. Confidence in findings was assessed with GRADE-CERQual.
Findings:
From 30 studies, 289 findings were synthesized into 12 key findings. According to findings, physical limitations, environmental barriers, social interactions, and personal expectations shaped activity, identity, independence, sexuality, and emotional adjustment. Prostheses, social support, and coping strategies facilitated engagement, while stigma, grief, fear, and financial strain posed challenges. Confidence levels were 7="high," 4= "moderate," 0="low," and 1="very low."
Clinical Relevance:
Rehabilitation and counseling programs for persons with major dysvascular lower limb amputations should integrate psychosocial assessment and individualized goals. Nurses can support patients by facilitating peer support, addressing emotional distress, and managing expectations around prosthetic use to promote independence, mobility, and social participation.
Conclusions:
Postdischarge psychosocial experiences for persons with major dysvascular lower limb amputations are multifaceted. Holistic, tailored approaches supporting autonomy, mobility, and emotional health are essential. Future research should consider cultural and health care system differences.
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