St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada.
St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.
Disabil Rehabil. 2023 Dec;45(24):4025-4034. doi: 10.1080/09638288.2022.2144492. Epub 2022 Nov 14.
Following major lower extremity amputation (LEA), patients experience significant emotional distress and are at risk for anxiety and depression. There is a lack of mental health supports for this population, and internet-based cognitive behavioural therapy (iCBT) may be a useful resource to meet this need. The purpose of this study was to use a qualitative approach to explore the mental health needs of LEA patients and to gauge their attitudes of the use of iCBT to help them cope with their amputation.
Semi-structured qualitative interviews were conducted with inpatients and outpatients with LEA recruited from a major urban rehabilitation hospital. Data were analysed using inductive codebook thematic analysis (TA).
Ten interviews were completed with individuals with LEA. The main themes identified were: (1) Fixating on the past; (2) Worry about the future; (3) Unmet mental health needs; (4) Barriers to Mental Health Support; (5) Importance of peer support; and (6) Tailoring iCBT.
Our findings highlight that patients with LEA are open to learning more about iCBT to meet their mental health needs. Key iCBT implementation considerations include taking into account issues of stigma associated with mental health, timing of delivery, levels of digital literacy, online security, and interactive content.IMPLICATIONS FOR REHABILITATIONFollowing lower extremity amputation (LEA), people experience significant emotional distress and are at risk for the development of anxiety and/or depression.Patients with LEA are receptive to an online mental health resource (i.e., internet-based cognitive behavioural therapy [iCBT]) but it needs to be tailored to meet the various mental health needs and digital literacy of the LEA population.The use of an implementation science approach can help identify factors related to the development and potential uptake of an iCBT for patients with LEA.
下肢截肢（LEA）后，患者会经历明显的情绪困扰，并面临焦虑和抑郁的风险。该人群缺乏心理健康支持，而基于互联网的认知行为疗法（iCBT）可能是满足这一需求的有用资源。本研究旨在采用定性方法探讨 LEA 患者的心理健康需求，并评估他们对使用 iCBT 帮助自己应对截肢的态度。
从一家主要的城市康复医院招募 LEA 的住院患者和门诊患者进行半结构式定性访谈。使用归纳式编码簿主题分析（TA）对数据进行分析。
共完成了 10 名 LEA 患者的访谈。确定的主要主题包括：（1）对过去的关注；（2）对未来的担忧；（3）心理健康需求未得到满足；（4）心理健康支持的障碍；（5）同伴支持的重要性；以及（6）iCBT 的定制。
我们的研究结果表明，LEA 患者对学习更多关于 iCBT 以满足他们的心理健康需求持开放态度。iCBT 实施的关键考虑因素包括考虑与心理健康相关的耻辱问题、交付时间、数字素养水平、在线安全性和互动内容。
下肢截肢（LEA）后，人们会经历明显的情绪困扰，并面临焦虑和/或抑郁的风险。LEA 患者对在线心理健康资源（即基于互联网的认知行为疗法[iCBT]）持开放态度，但需要根据 LEA 人群的各种心理健康需求和数字素养进行定制。
采用实施科学方法可以帮助确定与为 LEA 患者开发和潜在采用 iCBT 相关的因素。
