Compliance and satisfaction of lower limb amputees toward basic prostheses

Abstract

Background : King Chulalongkorn Memorial Hospital (KCMH) has been providing prosthetic services for more than 30 years. Due to the financial limitation of patients, most of the components prescribed for the lower limb prostheses were conditioned by the National Insurance allowance. These basic components have limitation regarding biomechanical properties that do little to restore the complex biomechanics of human walking, especially among patients, who are routinely active in daily life or need prostheses to work.

Objective : To explore compliance and satisfaction of lower limb amputees toward prostheses.

Study Design : Descriptive and analytical study.

Setting : Prosthetic-Orthotic (PO) Unit, Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital (KCMH).

Subjects : Lower extremity amputees who received prostheses from the PO Unit, KCMH.

Method : Patients’ records were reviewed. Amputees who met the criteria were contacted by phone and recruited into the study. Interviews were conducted at KCMH. Data collection was performed including demographic data, details of amputation, prosthetic device and its component, usability in daily living and the satisfaction with the prostheses and the service. Data analysis was performed by computerized statistical program.

Results : Thirty lower limb amputees were recruited into the study. Their average age was 60 years old and 60% of them were male. The majority were below knee amputees (27 patients, 90%). A total of 76.7% of the subjects were still using prostheses in their daily activities; 80% of the amputees graded the satisfaction level as “satisfied” or “most satisfied”. The factor that was significantly related to subjects’ satisfaction regarding the prosthetic devices and PO Unit services was the K-level. (P = 0.001, 0.002, respectively).

Conclusion : A total of 76.7% of lower limb amputees were still using the prostheses in daily activities. The majority (80%) had good and very good levels of satisfaction. This means the prostheses with basic components can generally be used by amputees with relatively good results. The K-level was significantly associated with satisfaction level. Thus, doctors and prosthetists should focus on explaining the objective and possibility of using the prostheses, which was correlated to K-level for individual patients. This could encourage using the prosthesis in individual patient’s functional capacity and also improve patient’s satisfaction.