Yetzer Elizabeth A, Schandler Steven, Root Tammy L, Turnbaugh Kathleen
Preservation-Amputation Care and Treatment (PACT) Program, VA HealthCare System, Long Beach, California, USA.
SCI Nurs. 2003 Spring;20(1):18-23.
Spinal cord injury (SCI) requires considerable psychological adjustment to physical limitations and complications. One particularly severe complication of SCI is foot skin breakdown, which can result in lower limb amputation. Relative to SCI adjustment, amputation may produce one of two psychological outcomes: (a.) the fragile self-concept of a person with SCI may be reduced further by limb amputation, or (b.) amputation of a diseased, nonfunctional limb may be associated with restored health and improved self-concept. To better understand the effects of amputation, 26 males with SCI, 11 of whom had a lower limb amputation, were administered the Tennessee Self-Concept Scale (TCS) and the Personal Body Attractiveness Scale (PBAS). The study revealed that persons with SCI with amputation had higher Physical and Total self-concept scores on the TSCS, showing a slightly more positive self-concept. On the PBAS, although there were no significant differences in the scores for the legs, ankles, or feet, the persons with SCI with amputation had higher score on the Satisfaction subscale, indicating a slightly greater satisfaction with their thigh in their body image. Implications for future study include replication with larger sample sizes, inclusion of women in the sample, and a longitudinal study. Several nursing interventions are identified.
脊髓损伤（SCI）需要对身体限制和并发症进行相当大的心理调适。SCI一种特别严重的并发症是足部皮肤破损，这可能导致下肢截肢。相对于SCI调适而言，截肢可能产生两种心理结果之一：（a）SCI患者脆弱的自我概念可能会因肢体截肢而进一步降低，或者（b）截去病肢、无功能的肢体可能与健康恢复和自我概念改善相关。为了更好地理解截肢的影响，对26名男性SCI患者（其中11人进行了下肢截肢）施测了田纳西自我概念量表（TCS）和个人身体吸引力量表（PBAS）。研究表明，截肢的SCI患者在TCS上的身体和总体自我概念得分更高，显示出略为积极的自我概念。在PBAS上，虽然腿部、脚踝或足部的得分没有显著差异，但截肢的SCI患者在满意度子量表上得分更高，表明他们对自己身体形象中的大腿部分满意度略高。对未来研究的启示包括采用更大样本量进行重复研究、样本中纳入女性以及开展纵向研究。还确定了几种护理干预措施。
