Abstract
Objective
To describe the relationship between caregiver-specific support and conflict, and
psychosocial outcomes among individuals experiencing their first dysvascular lower
extremity amputation (LEA).
Design
Cross-sectional cohort study using self-report surveys.
Setting
Department of Veterans Affairs, academic medical center, and level I trauma center.
Participants
Individuals undergoing their first major LEA because of complications of peripheral
arterial disease (PAD) or diabetes who have a caregiver and completed measures of
caregiver support and conflict (N=137; 94.9% men).
Interventions
Not applicable.
Main Outcome Measures
The Patient Health Questionnaire-9 to assess depression and the Satisfaction With
Life Scale to assess life satisfaction.
Results
In multiple regression analyses, controlling for global levels of perceived support,
self-rated health, age, and mobility, caregiver-specific support was found to be associated
with higher levels of life satisfaction and caregiver-specific conflict was found
to be associated with lower levels of life satisfaction and higher levels of depressive
symptoms.
Conclusions
The specific relationship between individuals with limb loss and their caregivers
may be an important determinant of well-being. Conflict with caregivers, which has
received little attention thus far in the limb loss literature, appears to play a
particularly important role. Individuals with limb loss may benefit from interventions
with their caregivers that both enhance support and reduce conflict.
Keywords
List of abbreviations:
CI (confidence interval), MSSS (Modified Social Support Survey), PAD (peripheral arterial disease), QRI (Quality of Relationship Inventory), SRH (self-rated health), SWLS (Satisfaction With Life Scale)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Estimating the prevalence of limb loss in the United States: 2005 to 2050.Arch Phys Med Rehabil. 2008; 89: 422-429
- Quality of life following lower limb amputation for peripheral arterial disease.Eur J Vasc Surg. 1993; 7: 448-451
- Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain.Pain. 1985; 21: 267-278
- Psychosocial adjustment to lower-limb amputation: a review.Disabil Rehabil. 2004; 26: 837-850
- Anxiety and depression following traumatic limb amputation: a systematic review.Injury. 2014; 45: 1859-1866
- Suicidal ideation among individuals with dysvascular lower extremity amputation.Arch Phys Med Rehabil. 2015; 96: 1404-1410
- Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer.Psycho-Oncology. 2007; 16: 474-486
- Social support and maladaptive coping as predictors of the change in physical health symptoms among persons living with HIV/AIDs.AIDS Patient Care STDS. 2005; 19: 587-598
- Social support and patient adherence to medical treatment: a meta-analysis.Health Psychol. 2004; 23: 207-218
- Adherence to disease-modifying therapies in multiple sclerosis: does caregiver social support matter?.Rehabil Psychol. 2008; 53: 73
- Direct and buffer effects of social support and personal coping resources in individuals with arthritis.Soc Sci Med. 1997; 44: 393-402
- Relationship quality and cpap adherence in patients with obstructive sleep apnea.Behav Sleep Med. 2009; 7: 22-36
- Family and disease management in african-american patients with type 2 diabetes.Diabetes Care. 2004; 27: 2850-2855
- Predictors of quality of life among individuals who have a lower limb amputation.Prosthet Orthot Int. 2008; 32: 231-243
- A two-year longitudinal study of social support following amputation.Disabil Rehabil. 2004; 26: 862-874
- The effect of rehabilitation in a comprehensive inpatient rehabilitation unit on mobility outcome after dysvascular lower extremity amputation.Arch Phys Med Rehabil. 2012; 93: 1384-1391
- Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain.Disabil Rehabil. 2004; 26: 882-893
- Phantom limb pain and residual limb pain following lower limb amputation: a descriptive analysis.Disabil Rehabil. 2001; 23: 522-530
- Psychosocial adaptation of children and adolescents with limb deficiencies: a review.Clin Psychol Rev. 1992; 12: 275-291
- A prospective study of positive adjustment to lower limb amputation.Clin Rehabil. 2009; 23: 1044-1050
Anderson DR, Roubinov D, Turner A, Williams R, Norvell D, Czerniecki J. Social support moderates the relationship between pre-surgical activities of daily living and depression after lower limb loss. Rehabil Psychol; In press.
- General and relationship-based perceptions of social support: are two constructs better than one?.J Pers Soc Psychol. 1991; 61: 1028
- The satisfaction with life scale.J Pers Assess. 1985; 49: 71-75
- Review of the satisfaction with life scale.Psychol Assess. 1993; 5: 164
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population.Gen Hosp Psychiatry. 2006; 28: 71-77
- Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population.Ann Fam Med. 2010; 8: 348-353
- Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9).J Affect Disord. 2004; 81: 61-66
- The MOS social support survey.Soc Sci Med. 1991; 32: 705-714
- Multiple sclerosis quality of life inventory: a user's manual.National Multiple Sclerosis Society, New York1997
- Prosthetic profile of people with lower extremity amputation: conception and design of a follow-up questionnaire.Arch Phys Med Rehabil. 1993; 74: 862-870
- Reliability, validity, and responsiveness of the locomotor capabilities index in adults with lower-limb amputation undergoing prosthetic training.Arch Phys Med Rehabil. 2004; 85: 743-748
- The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.Med Care. 1992; 30: 473-483
- Measuring disability with parsimony.Disabil Rehabil. 1999; 21: 295-306
- Assessing the clinical significance of single items relative to summated scores.Mayo Clin Proc. 2002; 77: 479-487
- Psychological response to amputation as a function of age and time since amputation.Br J Psychiatry. 1984; 144: 493-497
- The central role of restricted normal activities in adjustment to illness and disability: a model of depressed affect.Rehabil Psychol. 1998; 43: 327
- Body image, perceived social stigma, and the prediction of psychosocial adjustment to leg amputation.Rehabil Psychol. 1995; 40: 95-110
- To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.Rehabil Psychol. 2010; 55: 126
- Quality of couples' relationship and adjustment to metastatic breast cancer.J Fam Psychol. 2000; 14: 251
- Couples coping with chronic illness: women with rheumatoid arthritis and their healthy husbands.J Behav Med. 1990; 13: 327-342
- Couple-focused group intervention for women with early stage breast cancer.J Consult Clin Psychol. 2005; 73: 634
- Interventions with family caregivers of cancer patients: meta-analysis of randomized trials.CA Cancer J Clin. 2010; 60: 317-339
- Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs.Am J Psychiatry. 2005; 162: 250-256
Article Info
Publication History
Published online: October 05, 2017
Footnotes
Supported by the U.S. Department of Veterans Affairs, Office of Research and Development, Rehabilitation Research and Development (merit review no. A41241 and career development award no. B4927W).
The contents of this article do not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
