The Level of Psychosocial Adjustment and it’s Associated Factors among the Lower Limb Amputation with Prosthesis User Living in the Community: An Analytical Cross-Sectional

Abstract

Background: Experiencing limb amputation can be very challenging, often causing individuals to struggle with their body image, increased anxiety and depression, and changes in how they see themselves. It's crucial to understand the psychological and social well-being of individuals who have undergone amputation and the factors that influence it. This understanding is essential for providing comprehensive rehabilitation and support. Aim: To find out the level of psychosocial adjustment and associated factors among lower limb amputation with prosthesis users living in the community. Methods: The study used a cross-sectional quantitative design to conduct a telephone survey with 190 lower limb amputees who had received rehabilitation and prosthesis services from the Centre for the Rehabilitation of the Paralysed (CRP) in Savar. Standardised questionnaires (TAPES-R, ABIS-R, and HADS) were used to collect data on psychosocial adjustment, body image disturbance, anxiety, and depression. The data was analyzed using the SPSS 20 version for descriptive and inferential analysis. Results: The mean age of the individuals with lower limb amputee was 37.57±13.719 years. In terms of psychosocial adjustment, the general adjustment (15.91±2.374) and social adjustment (14.83±1.962) were higher than adjustment to limitation (12.27±2.204) among the participants. Daily use of prosthesis was 13-18 hours and had significantly higher scores for general adjustment (p<0.042). Farmers had significantly higher scores for social adjustment (p<0.033). The general adjustment was a weak positive correlation among duration of prosthesis use (r=.163, p<0.05; OR=.111, CI=.15-.207), daily use of prosthesis (r=.181, p<0.05; OR=.094, CI=.020-.169) and prosthesis satisfaction (r=.417, p<0.01; OR=.318, CI=.218-.418). The general adjustment also shows a weak negative correlation with activity restriction (r=-.147, p<0.05; OR=-.171, CI= -.259- -.083) and depression (r=-.269, p<0.01, OR=-.089, CI=-.175- -.003). Adjustment to limitation shows a weak positive correlation with depression (r=.170, p<0.05; OR=.096, CI=.016-.175), body image (r=.221, p< 0.01; OR=.121, CI=.044-.198), and activity restriction (r=.258, p<0.01; OR=.152, CI=.070-.233) and negative weak correlation with prosthesis satisfaction (r=-.157, p<0.05; OR= -.111, CI= -.211- -.010). The social adjustment had a positive weak correlation with prosthesis satisfaction (r=.275, p<0.01; OR=.173, CI= .086-.260) and conversely shows a negative correlation with daily use of prosthesis (r= 159, p<0.05; OR= -.069, CI= -.130- -.008) Conclusion: The findings suggest that individuals who used the prosthesis daily for more than thirteen hours reported high overall satisfaction. It was also noted that factors such as underlying anxiety, depression, body image, activity restriction, and prosthesis satisfaction were linked to psychosocial adjustment. Therefore, a comprehensive approach to amputee rehabilitation is crucial, encompassing physical, psychological, and social interventions to ensure holistic care and support. Keywords: Psychosocial adjustment, Persons with Lower Limb Amputation, Prosthesis.