Department of Family Medicine and Community Health, University of Massachusetts Medical School, Shrewsbury, MA, USA.
Disabil Rehabil. 2010;32(24):2046-55. doi: 10.3109/09638288.2010.481028. Epub 2010 May 4.
To explore the impact of childhood limb loss on families in terms of healthcare utilisation, schooling and parental labour supply.
Data were obtained from a cross-sectional, retrospective pilot survey of 123 parents or caregivers of children with limb loss selected randomly after stratification by aetiology (i.e. trauma, malignancy and congenital limb deficiency) from among eligible families identified by the Amputee Coalition of America. Healthcare utilisation, school (child) and labour market (parents) participation were examined.
Children with limb loss use health services frequently and miss school for limb loss-related concerns. Over half of all parents adjusted their work participation in response to their child's limb loss. The use of prostheses may increase direct and indirect costs of limb loss. Children with acquired limb loss (amputation following trauma or cancer) were more likely than those with a congenital limb deficiency to use a prosthesis.
Our data suggest that the impact of limb loss on families of affected children may include substantial costs, particularly when school and work effects are taken into account. Further research is needed to identify the full household- and societal-level costs of childhood limb loss and suggest interventions to reduce the burden experienced by families.
探讨儿童肢体缺失对家庭在医疗保健利用、就学和父母劳动力供应方面的影响。
数据来自美国截肢者联盟通过分层（即创伤、恶性肿瘤和先天性肢体缺陷）从合格家庭中随机选择的 123 名肢体缺失儿童的父母或照顾者的横断面、回顾性试点调查。调查了医疗保健利用、就学（儿童）和劳动力市场（父母）的参与情况。
肢体缺失的儿童经常使用医疗服务，并因肢体缺失相关问题而缺课。超过一半的父母为了应对孩子的肢体缺失而调整了工作参与。假肢的使用可能会增加肢体缺失的直接和间接成本。与先天性肢体缺陷相比，后天肢体缺失（创伤或癌症后截肢）的儿童更有可能使用假肢。
我们的数据表明，肢体缺失对受影响儿童家庭的影响可能包括大量成本，尤其是当考虑到上学和工作的影响时。需要进一步研究以确定儿童肢体缺失的全部家庭和社会层面的成本，并提出减轻家庭负担的干预措施。
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