Skip to main content

Adaptation to Amputation and Prosthesis Use

  • Chapter
  • First Online:
Book cover Amputation, Prosthesis Use, and Phantom Limb Pain

Abstract

In this chapter, we focus on psychosocial adaptation to an amputation/absence of a major limb and using a prosthesis. Prosthetic fitting, as a means of addressing cosmesis, functional rehabilitation and quality of life, is the most prevalent form of intervention for people with loss of a body part. However, the ways in which people respond to limb loss and the use of a prosthesis are both complex and individual and can be impacted upon by a variety of personal, clinical, social, physical and environmental factors. We term the study of the psychological, social and behavioural aspects of limb loss and prosthetic use, and of the rehabilitative processes in those conditions that require the use of prosthetic devices psychoprosthetics. In this chapter, we develop this concept and explore key issues including adaptation theory, body image, social discomfort and psychosocial factors impacting on adaptation such as coping, social support and culture. This chapter considers the importance of these issues for health service providers across the multidisciplinary team who work with people with limb loss. The integration of an awareness of psychosocial factors in the management of limb loss, together with physical and technical knowledge, is critical to optimising outcomes and enhancing appropriate service provision.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aminzadeh RN, Edwards R (1998) Exploring seniors’ views on the use of assistive devices in fall prevention. Public Health Nurs 15:297–305

    Article  PubMed  CAS  Google Scholar 

  • Bishop M (2005a) Quality of life and psychosocial adaptation to chronic illness and acquired disability: a conceptual and theoretical synthesis. J Rehabil 71:5–13

    Google Scholar 

  • Bishop M (2005b) Quality of life and psychosocial adaptation to chronic illness and disability: preliminary analysis of a conceptual and theoretical synthesis. Rehabil Couns Bull 48:219–231

    Article  Google Scholar 

  • Breakey JW (1997) Body image: the lower-limb amputee. J Prosthet Orthot 9:58–66

    Google Scholar 

  • Charmaz K (1983) Loss of self: a fundamental form of suffering in the chronically ill. Sociol Health Illn 5:168–197

    Article  PubMed  CAS  Google Scholar 

  • Charmaz K (1995) The body, identity and self: adapting to impairment. Sociol Q 36:657–680

    Article  Google Scholar 

  • Cohen S, Willis TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98:310–357

    Article  PubMed  CAS  Google Scholar 

  • Darnall BD, Ephraim PL, Wegener ST, Dillingham TR, Pezzin LE, Rossbach P, Mackenzie EJ (2005) Depressive symptoms and mental health service utilisation among persons with limb loss: results of a national survey. Arch Phys Med Rehabil 86:650–658

    Article  PubMed  Google Scholar 

  • Desmond D, MacLachlan M (2006) Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. Soc Sci Med 62:208–216

    Article  PubMed  Google Scholar 

  • Donovan-Hall MK, Yardley L, Watts RJ (2002) Engagement in activities revealing the body and psychosocial adjustment in adults with a trans-tibial prosthesis. Prosthet Orthot Int 26:15–22

    Article  PubMed  CAS  Google Scholar 

  • Dunn DS (1996) Well-being following amputation: salutary effects of positive meaning, optimism, and control. Rehabil Psychol 41:285–302

    Article  Google Scholar 

  • Eide AH, Øderud T (2009) Assistive technology in low income countries. In: MacLachlan M, Swartz L (eds) Disability and international development: towards inclusive global health. Springer, New York

    Google Scholar 

  • Festinger L (1954) A theory of social comparison processes. Hum Relat 7:117–140

    Article  Google Scholar 

  • Gallagher P, Desmond D, MacLachlan M (2008) Psychoprosthetics: an Introduction. In: Gallagher P, Desmond D, MacLachlan M (eds) Psychoprosthetics. Springer, London

    Chapter  Google Scholar 

  • Gallagher P, MacLachlan M (1999) Psychological adjustment and coping in adults with prosthetic limbs. Behav Med 25:117–124

    Article  PubMed  CAS  Google Scholar 

  • Gallagher P, MacLachlan M (2000a) Development and psychometric evaluation of the Trinity Amputation and Prosthesis Scales (TAPES). Rehabil Psychol 45:130–154

    Article  Google Scholar 

  • Gallagher P, MacLachlan M (2000b) Positive meaning in amputation and thoughts about the amputated limb. Prosthet Orthot Int 24:196–204

    Article  PubMed  CAS  Google Scholar 

  • Gallagher P, MacLachlan M (2001) Adjustment to an artificial limb: a qualitative perspective. J Health Psychol 6:85–100

    Article  Google Scholar 

  • Gallagher P, Horgan O, Franchignoni F, Giordano A, Maclachlan M (2007) Body Image in People with Lower-Limb Amputation: A Rasch Analysis of the Amputee Body Image Scale. Am J Phys Med 86:205–215

    Google Scholar 

  • Gauthier-Gagnon C, Grise MC, Potvin D (1998) Predisposing factors related to prosthetic use by people with a transtibial and transfemoral amputation. J Prosthet Orthot 10:99–109

    Article  Google Scholar 

  • Heinemann AW, Pape TL-B (2002) Coping and adjustment. In: Scherer MJ (ed) Assistive technology. Matching device and consumer for successful rehabilitation. American Psychological Association, Washington, DC

    Google Scholar 

  • Horgan O, MacLachlan M (2004) Psychological adjustment to lower-limb amputation: a review. Disabil Rehabil 26:837–850

    Article  PubMed  Google Scholar 

  • Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Czerniecki JM, Robinson LR (2002) Cognitions, coping and social environment predict adjustment to phantom limb pain. Pain 95:133–142

    Article  PubMed  Google Scholar 

  • Jonsson A, Moller A, Grimby G (1999) Managing occupations in everyday life to achieve adaptation. Am J Occup Ther 53:353–362

    PubMed  CAS  Google Scholar 

  • Kendall E, Buys N (1998) An integrated model for psychosocial adjustment following acquired disability. J Rehabil 64:16–20

    Google Scholar 

  • Livneh H (2001) Psychosocial adaptation to chronic illness and disability: a conceptual framework. Rehabil Couns Bull 44:151–160

    Article  Google Scholar 

  • Livneh H, Aantnak RF, Gerhardt J (1999) Psychosocial adaptation to amputation: the role of sociodemographic variables, disability related factors and coping strategies. Int J Rehabil Res 22:21–31

    Article  PubMed  CAS  Google Scholar 

  • MacLachlan M, Gallagher P (2004) Imagining the body. In: Gallagher P, MacLachlan M (eds) Enabling technologies: body image and body function. Edinburgh, Churchill-Livingstone, pp 3–20

    Google Scholar 

  • MacLachlan M (2004) Embodiment: clinical, critical and cultural perspectives on health and illness. Open University Press, Milton Keynes

    Google Scholar 

  • MacLachlan M (2006) Culture and health: a critical perspective towards global health. Wiley, Chichester

    Google Scholar 

  • MacLachlan M, Swartz L (eds) (2009) Disability and international development: towards inclusive global health. Springer, New York

    Google Scholar 

  • Melzack R (1975) The McGill pain questionnaire: major properties and scoring methods. Pain 1:255–299

    Google Scholar 

  • Murray C, Fox J (2002) Body image and prosthesis satisfaction in the lower limb amputee. Disabil Rehabil 24:925–931

    Article  PubMed  CAS  Google Scholar 

  • Murray CD (2008) Embodiment and prosthetics. In: Gallagher P, Desmond D, MacLachlan M (eds) Psychoprosthetics. Springer, London

    Google Scholar 

  • Nicholas JJ, Robinson LR, Schulz R, Blair C, Aliota R, Hairston G (1993) Problems experienced and perceived by prosthetic patients. J Prosthet Orthot 5:16–19

    Article  Google Scholar 

  • Nielson CC (1991) A survey of amputees: functional level and life satisfaction, information needs and the prosthetist’s role. J Prosthet Orthot 3:125–129

    Google Scholar 

  • Oaksford K, Frude N, Cuddihy R (2005) Positive coping and stress-related psychological growth following lower-limb amputation. Rehabil Psychol 50:266–277

    Article  Google Scholar 

  • Pape TL-B, Kim J, Weiner B (2002) The shaping of individual meanings assigned to assistive technology: a review of personal factors. Disabil Rehabil 24:5–20

    Article  Google Scholar 

  • Parker RM, Schaller J, Hansmann S (2003) Catastrophe, chaos and complexity models and psychosocial adjustment to disability. Rehabil Couns Bull 46:234–251

    Article  Google Scholar 

  • Phelps LF, Williams RM, Raichle KA, Turner AP, Ehde DM (2008) The importance of cognitive processing to adjustment in the 1st year following amputation. Rehabil Psychol 53:28–38

    Article  Google Scholar 

  • Rook KS (1990) Social relationships as a source of companionship: implications for older adults’ psychological well being. In: Saranson BR, Saranson IG, Pierce GR (eds) Social support: an international view. Wiley, New York

    Google Scholar 

  • Rybarczyk B, Edwards R, Behal J (2004) Diversity in adjustment to a leg amputation: case illustrations of common themes. Disabil Rehabil 26:944–953

    Article  PubMed  Google Scholar 

  • Rybarczyk B, Nicholas JJ, Nyenhuis D (1997) Coping with a leg amputation: integration research and clinical practice. Rehabil Psychol 42:241–256

    Article  Google Scholar 

  • Rybarczyk B, Nyenhuis D, Knussen C, Nicholas JJ, Cash SM, Kaiser J (1995) Body image, perceived social stigma, and the prediction of psychosocial adjustment to leg amputation. Rehabil Psychol 49:95–110

    Article  Google Scholar 

  • Rybarczyk B, Nyenhuis D, Nicholas JJ, Schulz R, Aliota R, Blair C (1992) Social discomfort and depression in a sample of adults with leg amputations. Arch Phys Med Rehabil 73:1169–1173

    PubMed  CAS  Google Scholar 

  • Rybarczyk B, Szymanski L, Nicholas JJ (2000) Psychological adjustment to a limb amputation. In: Frank R, Elliott T (eds) Handbook of rehabilitation psychology. American Psychological Association, Washington, DC

    Google Scholar 

  • Saranson B, Saranson I, Pierce G (1990) Social support: an international review. Wiley, New York

    Google Scholar 

  • Saranson B, Saranson IG, Gurung RAR (1997) Close personal relationships and health outcomes: a key to the role of social support. In: Duck S (ed) Handbook of personal relationships, 2nd edn. Wiley, Chichester, UK

    Google Scholar 

  • Scherer MJ (2000) Living in the state of stuck: how assistive technology impacts the lives of people with disabilities. Brookline Books, Cambridge, MA

    Google Scholar 

  • Schwarzer R, Knoll N, Rieckmann N (2004) Social support. In: Kapttein A, Weinman J (eds) Health psychology. BPS Blackwell, Oxford

    Google Scholar 

  • Sjodahl C, Gard G, Jarnlo G-B (2004) Coping after trans-femoral amputation due to trauma or tumour – a phenomenological approach. Disabil Rehabil 26:851–861

    Article  PubMed  CAS  Google Scholar 

  • Skevington SM (2004) Pain and symptom perception. In: Kaptein A, Weinman J (eds) Health psychology. BPS Blackwell, Oxford

    Google Scholar 

  • Spitzer RL, Kroenke K, Williams JBW (1999) Validation and utility of a self-report version of the PRIME-MD. J Am Med Assoc 282:1749–1756

    Article  Google Scholar 

  • Taleporos G, McCabe MP (2002) Body image and physical disability – personal perspectives. Soc Sci Med 54:971–980

    Article  PubMed  Google Scholar 

  • Taylor SE, Lobel M (1989) Social comparison activity under threat: downward evaluation and upward contacts. Psychol Rev 96:569–575

    Article  PubMed  CAS  Google Scholar 

  • Taylor SE, Wood JV, Lichtman RR (1983) It could be worse: selective evaluation as a response to victimization. J Soc Issues 39:19–40

    Article  Google Scholar 

  • Wallace M (2003) Try this. Best practices in nursing care to older adults: sexuality. Derm Nurs 15:570–571

    Google Scholar 

  • Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM (1993) The PTSD checklist: reliability, validity, and diagnostic utility. Annual meeting of the international society for traumatic stress studies, San Antonio, Texas

    Google Scholar 

  • Wegnner SW, Hofkamp SE, Ehde DM (2008) Interventions for psychological issues in amputation: a team approach. In: Gallagher P, Desmond D, MacLachlan M (eds) Psychoprosthetics. Springer, London

    Google Scholar 

  • Williams RM, Ehde DM, Smith DG, Czernieski JM, Hoffman AJ, Robinson LR (2004) A two-year longitudinal study of social support following amputation. Disabil Rehabil 26:962–874

    Article  Google Scholar 

  • Williamson GM (1995) Restrictions of normal activities among older adult amputees: the role of public self-consciousness. J Clin Geropsychol 1:229–242

    Google Scholar 

  • Williamson GM, Schulz R, Bridges MW, Behan AM (1994) Social and psychological factors in adjustment to limb amputation. J Soc Behav Pers 9:249–268

    Google Scholar 

  • Zeidner M, Endler N (1996) Handbook of coping: theory, research, applications. Wiley, New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pamela Gallagher .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Schaffalitzky, E., Gallagher, P., Desmond, D., MacLachlan, M. (2009). Adaptation to Amputation and Prosthesis Use. In: Murray, C. (eds) Amputation, Prosthesis Use, and Phantom Limb Pain. Springer, New York, NY. https://doi.org/10.1007/978-0-387-87462-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-87462-3_5

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-87461-6

  • Online ISBN: 978-0-387-87462-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics