Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 3 , Pages 328-333, March 2006

Environmental Barriers Experienced by Amputees: The Craig Hospital Inventory of Environmental Factors–Short Form

  • Patti L. Ephraim, MPH

      Affiliations

    • Limb Loss Research and Statistics Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
    • Corresponding Author InformationReprint 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
  • ,
  • Ellen J. MacKenzie, PhD

      Affiliations

    • Limb Loss Research and Statistics Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • ,
  • Stephen T. Wegener, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
  • ,
  • Timothy R. Dillingham, MD

      Affiliations

    • Departments of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI
  • ,
  • Liliana E. Pezzin, JD, PhD

      Affiliations

    • Medicine and Institute for Health Policy Studies, Medical College of Wisconsin, Milwaukee, WI

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.

Key Words:  Amputees , Disabled persons , Environment , Rehabilitation

 

 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.

PII: S0003-9993(05)01421-8

doi:10.1016/j.apmr.2005.11.010

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 3 , Pages 328-333, March 2006