The impact of lower limb amputation on quality of life among disabled patients at the orthopedic workshop university teaching hospitall

Abstract

Introduction: Disability following Lower Limb Amputation (LLA) is permanent and generally has an impact on the functional, psychological and social status of the individual. Quality of Life (QOL) is a subjective and multidimensional concept involving physical, emotional, functional and social domains. The loss of a limb may have a considerable impact on every aspect of a patient's QOL. Provision of better care for people with LLA begins with understanding the impact disability has on their QOL. Aim: The primary aim of this study was to determine the impact of LLA on QOL among disabled patients receiving rehabilitation services at the University Teaching Hospital (U.T.H) orthopedic workshop.Objectives: To establish the physical, psychological, social and environmental status of people with LLA, establish the factors influencing QOL in people with LLA and to establish the association between QOL status and demographic variables.Materials and methods: The study utilized a non-interventional, descriptive study design using quantitative methods. Data was collected using a 26-item WHOQOL-BREF instrument. It was self-administered for respondents who had sufficient ability but researcher-assisted and researcher-administered for most participants. Data was analyzed using the SPSS version 17. Descriptive statistics were used to report the level of QOL.Results: A total of 30 people participated in the study and the response rate was 100%. Among these, 60% were female and 40% were male. The age range of participants was 20-71 years with a mean and median age of 45 years. 53% were over the median age. The percentages of people with poor and good QOL were 60% and 40% respectively. Demographically participants who were younger than 45 years and employed had better QOL. Non-traumatic LLA, presence of co-morbidities, non-prosthesis use and dissatisfaction with a mobility aid were associated with poor QOL (p-values<0.05). Participants with lower scores of physical, psychological, social and environmental satisfaction had poor QOL. Factors with significant associations (p-value<0.05) with QOL included: age, employment status, co-morbidities, prosthesis use and satisfaction with mobility aid. Physical health, psychological well-being, social relationships and environmental satisfaction also influenced QOL.Conclusion: Generally, participants reported poor QOL. This was attributed to being female, being urban based, unemployed having a non-traumatic amputation and having a BKA (below knee amputation). Poor physical health predicted poor QOL due to old age, presence of co-morbidities and non use of prosthesis. Poor psychosocial well-being also predicted poor QOL due to shorter time passed since amputation, being unmarried and dissatisfaction with mobility aids. Participants dissatisfied with their environment had poor QOL. These factors predict outcome of QOL.