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Factors influencing psychological adjustment after amputation in adult lower limb amputees: A review

содержание презентации «Factors influencing psychological adjustment after amputation in adult lower limb amputees: A review.ppt»
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1Factors influencing psychological 20longitudinal designs, with appropriate
adjustment after amputation in adult lower control groups needed. Effect of ADM or
limb amputees: A review. Mark Hudson1, Dr. alcohol/drug use. Effect of repeated
Nathan Babiker2, & Dr. Ramesh Munjal2 infections.
1University of Sheffield & 2Sheffield 21Critique. Search limited to two
Teaching Hospitals NHS Foundation Trust. databases No hand-searching of journals
2Contents. Background literature Design Grey literature not consulted Written by
of the present review Results Clinical and one author Experts were not consulted.
research implications. 03/10/2015. © The 22References. Atherton, R. &
University of Sheffield. Robertson, N. (2006). Psychological
3Background literature. adjustment to lower limb amputation
4Definition. Psychological adjustment amongst prosthesis users. Disability and
to chronic disease involves at least five Rehabilitation, 28, 1201-1209 Coffey, L.,
key domains: Cognitive Emotional Gallagher, P., Horgan, O., Desmond, D.
Interpersonal Functional Disease-related & Maclachlan, M. (2009). Psychosocial
(Stanton, Revenson, & Tennen, 2007). adjustment to diabetes-related lower limb
5Horgan & MacLachlan (2004). amputation. Diabetic Medicine, 26,
Factors linked to better adjustment: 1063-1067. Couture, M., Desrosiers, J.,
Perceived sense of control Social support & Caron, C. D. (2011). Cognitive
Positive meaning Time since amputation appraisal and perceived benefits of
Cause (trauma or disease) had no dysvascular lower limb amputation: A
relationship. longitudinal study. Archives of
6Horgan & MacLachlan (2004). Gerontology and Geriatrics, 52, 5-11.
Factors linked to poorer adjustment: Body Desmond, D. M. & MacLachlan, M.
image anxiety Social discomfort Pain (2006a). Coping strategies as predictors
catastrophising Phantom limb pain Women of psychosocial adaptation in a sample of
and younger people in a sub-set. B/K elderly veterans with acquired lower limb
amputees more depressed in one study. amputations. Social Science &
03/10/2015. © The University of Sheffield. Medicine, 62, 208-216. Desmond, D.,
7Current review: Design. Gallagher, P., Henderson-Slater, D., &
8Rationale. Horgan & MacLachlan Chatfield, R. (2008). Pain and
(2004) called for more qualitative and psychosocial adjustment to lower limb
longitudinal research, and broader focus amputation amongst prosthesis users.
on QoL. Significant number of studies Prosthetics and Orthotics International,
published since the last review. 32, 244-252. Gunawardena, N., De A
Increasing awareness of psychological risk Senevirathne, R. & Athauda, T. (2007).
factors in the MDT. Increase own Mental health outcome of unilateral lower
understanding to assist with treatment limb amputee soldiers in two districts of
planning. Sri Lanka. International Journal of Social
9Search strategy. The Psychinfo and Web Psychiatry, 53, 135-147.
of Science databases were searched, from 23References. Hanley, M. A., Jensen, M.
2004 up until February 2013. The following P., Ehde, D. M., Hoffman, A. J.,
keyword search strategies were combined: Patterson, D. R., & Robinson, L. R.
“psychological” or “psychosocial” (2004). Psychosocial predictors of
“adjustment” or “adaptation” “amputation*” long-term adjustment to lower-limb
or “amputee*”. amputation and phantom limb pain.
10Selection criteria. Population: adults Disability and Rehabilitation, 26,
with a lower limb amputation Measures: At 882-893. Hawemdeh, Z. M., Othman, Y. S.,
least one amputation-related, & Ibrahim, A I. (2008). Assessment of
sociodemographic, or psychological anxiety and depression after lower limb
predictor variable. A validated criterion amputation in Jordanian patients.
measure of psychological adjustment. Neuropsychiatric Disease and Treatment, 4,
Analysis: at least one statistical test 627-633. Horgan, O., & MacLachlan, M.
examining the link between the predictor (2004).Psychosocial adjustment to lower
variables and criterion measures. Article limb amputation: a review. Disability and
type: English language articles in Rehabilitation, 26, 837–50. Jenkins, L.
peer-reviewed journals. M., Andrewes, D. G., Hale, T., Coetzee,
11Paper retrieval. N., & Khan, F. (2009). Subjective
12Results. attributes of depression, part 2: The
13Factors linked to better adjustment. contribution of self-perceived disability
Greater levels of hope (Unwin, Kacperek, to depression following stroke. Electronic
& Clarke, 2009) Positive cognitive Journal of Applied Psychology: General
processing (Phelps, Williams, Raichle, Articles, 5, 82-88. Kratz, A. L.,
Turner, & Ehde, 2008) Increased Williams, R. M., Turner, A. P., Raichle,
problem solving ability (Desmond & K. A., Smith, D. G., & Ehde, D.
MacLachlan, 2006a). Having a positive (2010). To lump or to split? Comparing
appraisal of the amputation (Couture, individuals with traumatic and
Desrosiers, & Caron, 2011). nontraumatic limb loss in the first year
14Factors linked to better adjustment. after amputation. Rehabilitation
Less phantom limb pain (Desmond et al. Psychology, 55, 126-138 Nunes, M. A., de
2008; Whyte & Carroll, 2004) Social Barros Jr, N., Miranda Jr, F., &
support (Williams et al., 2004; Unwin et Baptista-Silva, J. C. (2012). Common
al., 2009; Hanley et al., 2004; Desmond mental disorders in patients undergoing
& MacLachlan, 2006a; Hawemdah et al., lower limb amputation: A population-based
2008; Jenkins et al., 2008; Nunes et al., sample. World Journal of Surgery, 36,
2012; Singh et al., 2007) Below-knee 1011-1015.
amputation in sub-set (Desmond & 24References. Phelps, L. F., Williams,
Maclachlan, 2006a; Couture et al., 2011). R. M., Raichle, K. A., Turner, A. P.,
Number of co-morbidties (Nunes et al., & Ehde, D. M. (2008). The importance
2012; Singh et al., 2007; 2009). of cognitive processing to adjustment in
15Factors linked to worse adjustment. the 1st year following amputation.
Negative cognitive processing (Phelps et Rehabilitation Psychology, 53, 28-38.
al., 2008) Avoidance (Desmond & Singh, R., Hunter, J., & Philip, A.
MacLachlan, 2006a) Pain catastrophising (2007). The rapid resolution of depression
(Whyte & Carrol, 2004; Hanley et al., and anxiety symptoms after lower limb
2004) Public self-consciousness (Atherton amputation. Clinical Rehabilitation, 21,
& Robertson, 2006) Body-image 754-759. Singh, R., Ripley, D., Pentland,
disturbance (Coffey et al., 2009) Younger B., Todd, I., Hunter, J., Hutton, L.,
people (Gunawardena et al., 2007; Singh et & Philip, A. (2009). Depression and
al., 2009; Desmond & MacLachlan, 2006a anxiety symptoms after lower limb
) Female gender (Nunes et al., 2012). amputation: The rise and fall. Clinical
16Mixed Findings. Time since amputation Rehabilitation, 23, 281-286. Stanton, A.
Recent amputation more distressing L., Revenson, T. A., & Tennen, H.
(Desmond et al., 2006a; Nunes et al., (2007). Health psychology: Psychological
2012) Recent amputation less distressing adjustment to chronic disease. Annual
(Singh, 2007; 2009) Cause of amputation Review of Psychology, 58, 565-592. Unwin,
Disease related (Coffey et al., 2009; J., Kacperek, L., & Clarke, C. (2009).
Desmond & Maclachlan, 2006a; Couture A prospective study of positive adjustment
et al., 2011) Trauma related (Hawemdah et to lower limb amputation. Clinical
al., 2008; Kratz et al., 2010). Rehabilitation, 23, 1044-150. Whyte, A.
17Common methodological issues. & Carroll, L. J. (2004). The
Causality cannot be inferred Self-report relationship between catastrophizing and
bias Small sample sizes Selection bias disability in amputees experiencing
Lack of control groups Variability in phantom pain. Disability and
measurement tools. Rehabilitation, 26, 649-654. Williams, R.
18Clinical and research implications. M., Ehde, D. M., Smith, D. G., Czerniecki,
19Clinical implications. Highlights J. M., Hoffman, A. J. & Robinson, L.
those at risk of poor adjustment. R. (2004). A two-year longitudinal study
Indicates models of coping and resilience of social support following amputation.
(Lazarus & Folkman; 1984; Yates & Disability and Rehabilitation, 26,
Masten, 2004) Suggests therapy targets: 862-874.
Changing meaning Developing acceptance or 25Thank-you for listening. Any
active coping style Social support. Questions? Contact email:
20Research implications. Few studies on pcp12mh@sheffield.ac.uk.
residual limb pain. Pre-operative, 26To Discover And Understand.
Factors influencing psychological adjustment after amputation in adult lower limb amputees: A review.ppt
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Factors influencing psychological adjustment after amputation in adult lower limb amputees: A review

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