Environmental Barriers Experienced by Amputees: The Craig Hospital Inventory of Environmental Factors–Short Form
Abstract
Ephraim PL, MacKenzie EJ, Wegener ST, Dillingham TR, Pezzin LE. Environmental barriers experienced by amputees: the Craig Hospital Inventory of Environmental Factors–Short Form.
Objectives
To describe the prevalence of perceived environmental barriers in a population of amputees; to compare and contrast those barriers reported by amputees with reported barriers of a sample of disabled and nondisabled persons; and to identify the correlates of barriers among amputees.
Design
Cross-sectional survey.
Setting
A community sample who were interviewed by telephone.
Participants
A stratified sample by etiology of 914 community-dwelling persons with limb loss.
Intervention
Telephone interview.
Main Outcome Measures
Frequency (never, less than monthly, monthly, weekly, daily) and magnitude (little problem, big problem) of perceived environmental barriers in 5 domains as measured by the Craig Hospital Inventory of Environmental Factors–Short Form (CHIEF-SF), characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee.
Results
The majority (87%) of persons surveyed reported barriers in 1 or more areas with 57% reporting barriers in 4 or more of the 5 domains (policies, physical/structural, work/school, attitudes/support, and services/assistance subscales). Mean frequency-magnitude scores were lower for amputees with cancer-related amputation across all subscales, while traumatic amputees reported the greatest perceived barriers, except in the area of services/assistance. Across all domains, poverty level and comorbidity were significant predictors of significant barriers (CHIEF-SF score ≥3; range, 0–8). When compared with a general population sample of disabled and nondisabled Americans, amputees were more likely to perceive barrier in all areas except work/school.
Conclusions
Perceived environmental barriers among persons with limb loss are highly prevalent. Reduction of environmental barriers may lead to reduction of disability and improvement of overall quality of life for amputees.
aLimb Loss Research and Statistics Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
bDepartment of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
cDepartments of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI
dMedicine and Institute for Health Policy Studies, Medical College of Wisconsin, Milwaukee, WI
Reprint requests to Patti L. Ephraim, MPH, Limb Loss Research and Statistics Program, Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Rm 502, Baltimore, MD 21205
Supported by the National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC) (grant no. U59/CCU416733). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of CDC.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
ABSTRACT