Sinha Richa, van den Heuvel Wim J A, Arokiasamy Perianayagam, van Dijk Jitse P
aDepartment of Community and Occupational Health, Research Institute SHARE, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands bDepartment of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, India.
Int J Rehabil Res. 2014 Mar;37(1):74-9. doi: 10.1097/MRR.0000000000000038.
The objectives of this study are to investigate the relationship between adjustments to amputation and artificial limb, and quality of life (QoL), and to analyse the influence of sociodemographic, medical and amputation-related factors on this relationship. Patients with unilateral and noncongenital lower limb amputation who were using artificial limb were interviewed (n=368) using structured questionnaires. The Trinity Amputation and Prosthesis Experience Scales (TAPES) were used to assess adjustments to amputation and artificial limb and the MOS Short-Form Health Survey (SF-36) was used to assess the physical (PCS) and mental (MCS) component summary of QoL. Absence of comorbidity and residual stump pain, being employed, young age, less functional restriction, being more adjusted to limitation, increased social adjustment and less restriction in athletic activity were related to better PCS scores. Absence of comorbidity and phantom limb pain, nonuse of assistive device, being more adjusted to limitation, increased social adjustment and being less functionally restricted were related to higher MCS scores. Comorbidity had a modifying effect on both PCS and MCS scores. In addition, age, being employed and residual stump pain had a modifying influence on PCS, whereas assistive device use and phantom limb pain had a modifying influence on MCS. Our findings show that TAPES subscales have a modifying effect on the associations between several background (sociodemographic and amputation characteristics) and QoL (PCS and MCS). This indicates that adjustments to amputation and artificial limb are the key determinants of QoL in individuals following lower limb amputation.
本研究的目的是调查截肢与假肢调整和生活质量（QoL）之间的关系，并分析社会人口统计学、医学和截肢相关因素对这种关系的影响。对使用假肢的单侧非先天性下肢截肢患者（n = 368）进行了结构化问卷调查。使用三位一体截肢与假肢体验量表（TAPES）评估截肢与假肢调整情况，使用医学结局研究简短健康调查（SF - 36）评估生活质量的身体（PCS）和心理（MCS）成分总结。无合并症和残肢疼痛、就业、年轻、功能受限较少、更适应限制、社会适应能力增强以及体育活动受限较少与更好的PCS得分相关。无合并症和幻肢痛、不使用辅助装置、更适应限制、社会适应能力增强以及功能受限较少与更高的MCS得分相关。合并症对PCS和MCS得分均有调节作用。此外，年龄、就业情况和残肢疼痛对PCS有调节影响，而辅助装置的使用和幻肢痛对MCS有调节影响。我们的研究结果表明，TAPES分量表对几个背景因素（社会人口统计学和截肢特征）与生活质量（PCS和MCS）之间的关联有调节作用。这表明截肢与假肢调整是下肢截肢患者生活质量的关键决定因素。
