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A Longitudinal Study of Social Participation After Dysvascular Lower Extremity Amputation

Roepke, Ann Marie PhD; Williams, Rhonda M. PhD; Turner, Aaron P. PhD; Henderson, Alison W. PhD; Norvell, Daniel C. PhD; Henson, Helene MD; Hakimi, Kevin N. MD; Czerniecki, Joseph M. MD

American Journal of Physical Medicine & Rehabilitation: October 2017 - Volume 96 - Issue 10 - p 741–747
doi: 10.1097/PHM.0000000000000745
Original Research Articles

Objective This study examined patterns of social participation among individuals experiencing their first dysvascular lower extremity amputation. We identified the types of social participation valued by this population and explored factors that were associated with individuals' levels of participation and their subjective satisfaction with participation.

Design A prospective cohort was recruited from four Veterans Administration Medical Centers and followed for 1 yr after amputation. Social participation was measured with a modified version of the Community Integration Questionnaire. Potential correlates included the Patient Health Questionnaire-9, Modified Social Support Survey, Locomotor Capability Index 5, Short Portable Mental Status Questionnaire, and self-rated health.

Results At 1-yr postamputation, participants indicated that the most valued aspects of social participation were maintaining close friendships, visiting loved ones, and managing finances. Levels of social participation and satisfaction with participation were modest at 1-yr postamputation. Higher levels of social participation at 1 yr were related to better baseline mental status, better premorbid mobility, and lower amputation level. Higher satisfaction with participation was related to greater baseline social support.

Conclusions Individuals' social participation may be influenced by physical and cognitive factors, whereas their satisfaction with participation may be influenced by psychosocial factors. Rehabilitation specialists are encouraged to address both aspects of social participation when formulating and pursuing rehabilitation goals.

From the VA Puget Sound Health Care System, Rehabilitation Care Service, Seattle, Washington (AMR, RMW, APT, AWH, KNH, JMC); University of Washington, Department of Rehabilitation Medicine, Seattle, Washington (RMW, APT, KNH, JMC); Spectrum Research, Inc, Tacoma, Washington (DCN); and Houston VA Medical Center, Physical Medicine and Rehabilitation, Houston, Texas (HH).

All correspondence and requests for reprints should be addressed to: Ann Marie Roepke, PhD, VA Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108.

This material is based on work supported by the US Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development (Merit Review A41241: Joseph Czerniecki, principal investigator, and Career Development Award B4927W: Aaron Turner, principal investigator). Writing of this article was also supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs.

The contents of this article do not represent the views of the US Department of Veterans Affairs or the United States government.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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