The Trinity amputation and prosthesis experience scales and quality of life in people with lower-limb amputation 1,

https://doi.org/10.1016/j.apmr.2003.07.009Get rights and content

Abstract

Gallagher P, MacLachlan M. The Trinity Amputation and Prosthesis Experience Scales and quality of life in people with lower-limb amputation. Arch Phys Med Rehabil 2004;85:730–6.

Objectives

To undertake preliminary research into quality of life (QOL) for a group of people with a lower-limb amputation and to investigate what aspects of the “prosthetic experience” are most strongly associated with QOL using the Trinity Amputation and Prosthesis Experience Scales (TAPES).

Design

Cross-sectional survey.

Setting

Prosthetic limb fitting center.

Participants

Sixty-three people older than 18 years with unilateral lower-limb amputation.

Interventions

Not applicable.

Main outcome measures

The TAPES and the World Health Organization Quality of Life Questionnaire—Brief Version.

Results

There were no significant differences in any of the QOL domain scores (physical health, psychological, social relationships, environmental) arising from age, gender, level of amputation, or cause of amputation. However, there were significant differences depending on the length of time living with the prosthesis and the degree of prosthetic use. Stepwise regression identified different significant predictors for each domain of QOL.

Conclusions

These findings support the claim that the TAPES can be used to evaluate QOL for this patient group. Further research is warranted to learn how sensitive the scale and its items are to change in clinical status.

Section snippets

Participants

Of 169 potential respondents, 63 people (37% response rate) returned completed questionnaires and were included in this study. The characteristics of the sample are outlined in table 1. As can be seen, the sample was predominantly male, with the prevalent cause of amputation being trauma or accident. In addition, the most common level of amputation was below knee.

World Health Organization Quality of Life Questionnaire

The World Health Organization Quality of Life Questionnaire (Brief Version)37 (WHOQOL-BREF) considers QOL as a broad-ranging concept

Results

There were no significant relationships between age and each of the QOL domain scores. There was a significant relationship between length of time living with the prosthesis and each of physical health (r=.26, P<.05), social relationships (r=.29, P<.05), and the environment (r=.33, P<.01) scales on the WHOQOL. There was also a significant relationship between degree of prosthetic use and both the psychological domain (r=.29, P<.05) and the social relationships domain (r=.50, P<.001). There were

Discussion

The ability of the TAPES to predict a significant amount of variance for each of the 4 domains of QOL identified by the WHOQOL highlights the potential usefulness of the TAPES as a disorder-specific index of QOL for amputees. In particular, the ability of the TAPES to account for 84% of the variance in the physical domain of QOL is indicative of the usefulness of the general adjustment subscale, functional restriction subscale, physical capabilities rating, experience of residual limb pain,

Conclusions

We have undertaken an important analysis for the further validation of a recently developed disability-specific instrument and have shown its salience to a highly generic, multidimensional QOL assessment. These findings provide preliminary evidence that the TAPES can be used to evaluate changes in QOL during the rehabilitation process and to provide insights into the nature of the disability experienced, by assessing how it impairs the subjective well-being of the person across a series of

Acknowledgements

We thank the staff from Cappagh Orthopaedic Hospital, Dublin, Ireland who facilitated this research. The TAPES are available and may be downloaded at http://www.tcd.ie/psychoprosthetics.

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    Supported by the National Disability Authority (formerly the National Rehabilitation Board) in Ireland and Trinity College Dublin.

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