Age and health-related quality of life, general self-efficacy, and functional level 12 months following dysvascular major lower limb amputation: a prospective longitudinal study

• Published in: Disability and rehabilitation 2019-11, Vol.41 (24), p.2900-2909
• Main Authors: Madsen, Ulla Riis, Baath, Carina, Berthelsen, Connie Boettcher, Hommel, Ami
• Format: Article
• Language: English
• Subjects: Clinical Medicine; Dysvascular amputation; functional level; General Self-Efficacy; Geriatrics; Geriatrik; Health Sciences; Health-Related QOL; Hälsovetenskap; Klinisk medicin; lower limb amputation; Medical and Health Sciences; Medicin och hälsovetenskap; non-traumatic amputation; Nursing Science; Omvårdnad; Physiotherapy; Sjukgymnastik
• ISSN: 0963-8288; 1464-5165; 1464-5165
• DOI: 10.1080/09638288.2018.1480668

Aim: This study investigates the effect of time and age on health-related quality of life, general self-efficacy, and functional level 12 months following dysvascular major lower limb amputation (LLA). Methods: A prospective cohort study design with assessments at baseline and follow-up 3, 6, and 12 months post-amputation. Data were collected via in-person interviews using Short Form 36, the General Self-efficacy scale and Barthel Index 100. Out of a consecutive sample of 103 patients having dysvascular major LLA (tibia, knee, or femoral), 38 patients completed the study. Outcome at follow-up was compared with baseline and analyzed in age groups. Results: All SF36 subscale scores were below population norms at baseline. At 12 months, two out of eight scores-physical function and role-physical-had not improved. Different patterns of change over the 12 months were detected among the subscales, and psychosocial problems persisted and fluctuated throughout the 12 months in all age groups. Large differences were identified between age groups in physical function with the loss of physical function almost solely evident among the oldest (aged 75+ years) patients. Conclusions: Special attention should be given to the oldest patients need for rehabilitation so that they gain higher quality of life. Implications for rehabilitation Psychosocial problems persist and fluctuate throughout the first 12 months after major LLAs in all age groups and rehabilitation services should include psychosocial support throughout the first year to all patients independent of age. Waiting for an unnecessarily long period of time for a prosthesis can negatively impact both physical and psychosocial aspects of health-related QOL, and interventions to reduce waiting time are warranted. Differences between age groups in functional level after 12 months exist, with the loss of function almost solely evident among the oldest patients (aged 75+ years). A special focus should be given to the oldest patients' need of everyday rehabilitation to regain basic physical functions.