Leidos, San Diego, CA, USA.
Operational Readiness Research Directorate, Naval Health Research Center, San Diego, CA, USA.
Disabil Rehabil. 2022 Jun;44(13):3189-3195. doi: 10.1080/09638288.2020.1863481. Epub 2020 Dec 23.
Service members with amputations experience numerous challenges, yet few studies have examined patient-reported outcomes, including physical functional status, mental-health screening status, and quality of life (QOL) or the relationship between these outcomes.
Service members with combat-related lower extremity amputations ( = 82) and participants in the Wounded Warrior Recovery Project were included. Patient-reported outcomes of physical functional status, posttraumatic stress disorder (PTSD), depression screening status, and QOL were compared, while accounting for amputation level. Linear regression assessed relationships between physical functional status and QOL, as well as mental-health screening status.
Higher physical functioning scores were associated with better QOL, and lower physical functioning scores were associated with screening positive for PTSD or depression. When stratified by mental-health screening, a significant relationship was observed between mean physical functioning scores and amputation level with a negative PTSD or depression screen only. Additionally, those with bilateral amputation reported lower physical functioning.
Physical functioning was associated with patient-reported outcomes, including QOL and mental-health screening. Screening positive for PTSD or depression was associated with worsened self-reported physical function and may outweigh the impact of amputation severity on physical functioning. Successful rehabilitation requires the integration of physical and mental health domains in order to achieve optimal functioning.Implications for rehabilitationThe current study shows that physical functioning in participants with combat-related amputation is related to the amputation level, quality of life, and mental-health symptom screening.Good mental health is crucial to optimal functioning, as presence of adverse mental-health symptoms may exacerbate physical functional limitations among those with combat-related amputations.Assessing variables related to adverse mental-health symptoms and ultimate physical functioning outcomes is critical for clinicians to optimize rehabilitative strategies and outcomes.
截肢的军人会面临许多挑战，但很少有研究调查过患者报告的结果，包括身体功能状况、心理健康筛查状况以及生活质量（QOL）或这些结果之间的关系。
研究纳入了 82 名患有与战斗相关的下肢截肢的军人和参与“受伤战士康复项目”的参与者。比较了身体功能状况、创伤后应激障碍（PTSD）、抑郁筛查状况和 QOL 的患者报告结果，同时考虑了截肢水平。线性回归评估了身体功能状况与 QOL 以及心理健康筛查状况之间的关系。
更高的身体功能评分与更好的 QOL 相关，而较低的身体功能评分与 PTSD 或抑郁筛查阳性相关。当按心理健康筛查分层时，仅在 PTSD 或抑郁筛查阴性的情况下，观察到平均身体功能评分与截肢水平之间存在显著关系。此外，双侧截肢的人报告身体功能更差。
身体功能与患者报告的结果相关，包括 QOL 和心理健康筛查。PTSD 或抑郁筛查阳性与自我报告的身体功能恶化相关，可能超过截肢严重程度对身体功能的影响。成功的康复需要整合身体和心理健康领域，以实现最佳功能。
目前的研究表明，与战斗相关的截肢参与者的身体功能与截肢水平、生活质量和心理健康症状筛查有关。良好的心理健康对最佳功能至关重要，因为存在不良心理健康症状可能会加剧那些与战斗相关的截肢者的身体功能限制。评估与不良心理健康症状和最终身体功能结果相关的变量对于临床医生优化康复策略和结果至关重要。
