Patient satisfaction following below knee prosthesis fitting

Abstract

Background: Prosthesis use has become the main mode of rehabilitation of patients following limb amputation. The main aim of the prosthesis use is for the patient to regain most of their previous function. There is however minimal data on outcome and satisfaction of patients following this rehabilitation in our setting. Objective: The aim of the study was to look at patient satisfaction following below knee prosthesis fitting post amputation patients who have been put on prosthesis over a period of 6 weeks. Study design: This was a descriptive prospective study conducted in Prosthesis clinic at KNH, PCEA Kikuyu and AIC CURE Kijabe hospitals. Methods and Materials: Patients with below knee amputations were recruited in the study consecutively after giving a written informed consent over a period of 6 weeks. The sample size was 45. In minors, consent was sought from parents and /or guardians. The patients were followed over 6 weeks with reviews done at week 0 and 6. Patient satisfaction were assessed using the SF-36 health questionnaire which is a validated questionnaire used to monitor patient satisfaction to treatment. The scores of the form were compared to the different biosocial and physiological characteristics of the patient. Data collected was analyzed using SPSS version 20 and presented as graphs and charts. Results: The participants were mainly male (64.4%), with a mean age of 41.8 years and a range of 14-88 years. Average waiting time between amputation and prosthesis fitting was 5.9 months. Pain was the main complication (44.4% of the participants) and it was graded at different levels. Age was found to be associated with presence of complication (p value 0.032) with patients over 40 years more likely to develop complications. SF36 form scores calculated for physical and mental health were 64.9% and 75.5% respectively. The physical functioning score was 50.6%. Patient role limitation was more due to physical health (58.9%) as compared to emotional health (81.5%). Social function scores were at 73.1%. Conclusion: The study showed that prosthesis use remains a key element in management of an amputee and ensures good emotional, social and physical functioning scores. Recommendation: A long term study is recommended to enable serial follow up on the satisfaction levels and use of walk tests for better quantitative data. Policy development for management of amputees is also encouraged to allow for better outcomes. Limitations: Patient bias due to use of a questionnaire as a data collecting tool may have occurred. Short duration of the study, although the SF36 form has been shown to be adequate in measuring changes within a minimum of 4 weeks following a health intervention.