- •Thirteen upper limb amputees, who had received an aesthetic prosthesis, were interviewed.
- •Individual variations concerning the experienced emotional consequences were identified.
- •Adaptation strategies and the role of the prosthesis were described.
An amputation injury to the hand may lead to not only impaired hand function but also psychosocial consequences.
Purpose of the Study
The purpose of the study was to explore personal experiences of social participation for persons provided with an esthetic prosthesis after acquired upper limb amputation.
Thirteen persons with acquired upper limb amputation, who were in need of and had received an esthetic prosthesis, were interviewed. The transcribed text was subjected to content analysis.
The emotional reactions to a visibly different hand were linked to a changed appearance and a feeling of being exposed. Recollecting the accident could result in nightmares and sleeping disorders. A change of personality, due to sadness after the amputation was expressed, as well as social insecurity and impact on relations and life roles. Adapting to social challenges comprised hiding or exposing the hand, using personal internal resources and receiving support from others. The esthetic prosthesis contributed to an intact appearance and could serve as a facilitator for initial or long-term social participation. The time that had passed since the injury made it easier to deal with the consequences or in achieving acceptance.
Coping with emotions and social relations after an acquired amputation can be difficult and complex.
Individual needs must be considered and questions about appearance and how it may affect social participation must be asked. An esthetic prosthesis can normalize the appearance and offer the confidence needed to facilitate social participation in those struggling with appearance-related concerns.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Therapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Incidence of traumatic peripheral nerve injuries and amputations in Sweden between 1998 and 2006.Neuroepidemiology. 2009; 32: 217-228
- Anxiety and depression following traumatic limb amputation: a systematic review.Injury. 2014; 45: 1859-1866
- The social meanings of prosthesis use.J Health Psychol. 2005; 10: 425-441
- Being like everybody else: the personal meaning of being av prosthesis user.Disabil Rehabil. 2009; 31: 573-581
- The experience of men using an upper limb prosthesis following amputation: positive coping and minimizing feeling different.Disabil Rehabil. 2008; 30: 871-883
- Types, causes and physical treatments of visible differences.in: Lansdown R. Rumsey N. Bradbury E. Carr T. Partridge J. Visibly Different: Coping with Disfigurement. Butterworth-Heinemann, Oxford; Boston1997
- Adjustment to an artificial limb: a qualitative perspective.J Health Psychol. 2001; 6: 85-100
- Adaptation to hand injury: an evolving experience.Am J Occup Ther. 2004; 58: 128-139
- Coping strategies used by people with a major hand injury: a review of the literature.Brit J Occup Ther. 2014; 77: 289-295
- Hand injuries and disorders during the life cycle; consequences, adaptation and therapeutic approach.in: Hayre C.M. Muller D. Enhancing Healthcare and Rehabilitation: The Impact of Qualitative Research. Taylor and Francis: CRC Press, New York2019: 167-184
- Forearm amputees' views of prosthesis use and sensory feedback.J Hand Ther. 2015; 28 (quiz 278): 269-277
- Environmental barriers, activity limitations and participation restrictions experienced by people with major limb amputations.Prosthet Orthot Int. 2011; 35: 278-284
- International Classification of Functioning, Disability and Health.World Health Organization, Geneva2001
- Enhancing the conceptual clarity of the activity and participation components of the international classification of functioning, disability and health.Soc Sci Med. 2008; 66: 2335-2345
- Participation and social participation: are they distinct concepts?.Clin Rehabil. 2014; 28: 211-220
- Aesthetic hand prosthesis: gadget or therapy? Presentation of a new classification.J Hand Surg Br. 2001; 26: 523-528
- Qualitative Research Methods for the Social Sciences.8th ed. Pearson Education, Upper Saddle River, NY2012
- A prospective evaluation of the Modified Hand Injury Severity Score in predicting return to work.Int J Surg. 2008; 6: 45-50
- The hand injury severity scoring system.J Hand Surg Br. 1996; 21: 295-298
- Are the ICF activity and participation dimensions distinct?.J Rehabil Med. 2003; 35: 145-149
- Participation in the occupations of everyday life.Am J Occup Ther. 2002; 56: 640-649
- What does participation mean? An insider perspective from people with disabilities.Disabil Rehabil. 2008; 30: 1445-1460
- Saturation in qualitative research: exploring its conceptualization and operationalization.Qual Quant. 2018; 52: 1893-1907
- SF-36 Hälsoenkät: Svensk Manual Och Tolkningsguide, 2:a Upplagan.Sahlgrenska University Hospital, Gothenburg2002
- Measuring participation according to the international classification of functioning, disability and health (ICF).Disabil Rehabil. 2003; 25: 577-587
- Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.Nurs Educ Today. 2004; 24: 105-112
- Three approaches to qualitative content analysis.Qual Health Res. 2005; 15: 1277-1288
- Body image and disfigurement: issues and interventions.Body Image. 2004; 1: 83-97
- Changes in life roles after hand injury.J Hand Ther. 2007; 20 (quiz 69): 57-68
- Bottom-up or top-down evaluation: is one better than the other?.Am J Occup Ther. 2004; 58: 594-599
- Stigma of visible and invisible chronic conditions.J Adv Nurs. 2000; 32: 243-248
- Stigma. Notes on the Management of Spoiled Identity.Prentice-Hall, Englewood Cliffs, NJ1963
- Adjusting to disfigurement: processes involved in dealing with being visibly different.Clin Psychol Rev. 2001; 21: 663-682
- Young women with breast burns: a self-help "group by mail.J Burn Care Rehabil. 1992; 13: 44-47
- Enhancing the Quality and Credibility of Qualitative Analysis.Health Serv Res. 1999; 34: 1189-1208
- The use of triangulation in qualitative research.Oncol Nurs Forum. 2014; 41: 545-547
JHT Read for Credit
Quiz: # 716
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- c.case series
- d.single case report
- # 2.Data were gathered using
- a.chart reviews
- c.outcome surveys
- d.semi-structured interviews
- # 3.The data collection was performed by
- a.a committee of 10 and included therapists and surgeons
- b.3 therapists
- c.the lead author
- d.a committee of 5 and included social workers and psychologists
- # 4.Participants completed the
- b.Short Form 36
- d.Mayo Clinic Prosthetic Survey
- # 5.Some, but not all, participants felt an aesthetic prosthesis was of significant benefit in social situations
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Published online: May 09, 2019
Accepted: March 20, 2019
Received in revised form: March 18, 2019
Received: March 14, 2018
This study was supported by grants from the Healthcare Academy at Skane University Hospital.
© 2019 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.