Whyte A S, Carroll L J
Scottish Network for Chronic Pain Research, University of Stirling, Stirling FK9 4LA, Scotland, UK.
Disabil Rehabil. 2002 Jun 15;24(9):462-70. doi: 10.1080/09638280110105213.
To examine amputees' use of health, social and voluntary services and to assess the perceived benefit of such use. Additionally, to examine the degree and type of changes made in occupational status in relation to both pain and prosthetic limb use following amputation.
A survey methodology was employed to examine the services used by amputees and their experiences of occupational change. A response rate of 62% resulted in 315 amputees completing the study. The study sample was drawn from patient records at three artificial limb and appliance centres in the central belt of Scotland.
Overall the data suggest that few amputees make use of the available services for general amputation-related problems. Even fewer services were utilized for phantom limb pain or for other pain problems. Moreover, of those services that were used, very few were reported as being helpful. Amputation had severe consequences in terms of employment with 75% of the sample in employment prior to the amputation and only 43.5% remaining following amputation. Additionally, of those who did remain in employment there were a number of changes from pre- to post-amputation occupational classification. Employment status was related to the intensity of phantom limb pain, and daily prosthetic limb use with unemployed amputees reporting higher levels of pain and lower levels of prosthesis use.
The study demonstrates the need for further research to determine whether the results obtained regarding occupational changes following amputation result pain, disability, amputees' attitudes towards themselves in relation to work, or to employers' attitudes and beliefs about their capabilities. Further research is also required to determine why so few amputees make use of available services and why, even when they are used, such services are not perceived as being helpful. Finally, there is a need to clarify the relationship between the extent of daily prostheses use, the experience of phantom limb pain and employment status.
研究截肢者对健康、社会和志愿服务的使用情况，并评估这种使用所带来的感知益处。此外，研究截肢后职业状况相对于疼痛和假肢使用所发生的变化程度及类型。
采用调查方法来研究截肢者使用的服务及其职业变化经历。62%的回复率使得315名截肢者完成了该研究。研究样本取自苏格兰中部地区三个人造肢体与器具中心的患者记录。
总体而言，数据表明很少有截肢者利用现有的服务来解决一般的截肢相关问题。用于幻肢痛或其他疼痛问题的服务更少。而且，在那些使用过的服务中，很少有被报告为有帮助的。截肢在就业方面产生了严重后果，截肢前样本中有75%就业，截肢后仅43.5%仍在就业。此外，在那些仍在就业的人中，截肢前后职业分类有一些变化。就业状况与幻肢痛的强度以及假肢的日常使用有关，失业的截肢者报告的疼痛程度更高，假肢使用水平更低。
该研究表明需要进一步开展研究，以确定截肢后职业变化的结果是由疼痛、残疾、截肢者对自身工作的态度，还是雇主对其能力的态度和信念所导致。还需要进一步研究来确定为什么如此少的截肢者利用现有的服务，以及为什么即使使用了这些服务，也不认为它们有帮助。最后，有必要阐明假肢日常使用程度、幻肢痛体验和就业状况之间的关系。
