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活动与参与、双手功能以及假肢满意度是上肢假肢使用者总体幸福感的有力预测指标。

Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users.

作者信息

Stevens Phillip M, England Dwiesha L, Todd Amy E, Mandacina Stephen A, Wurdeman Shane R

机构信息

Hanger Institute for Clinical Research and Education, Austin, TX.

Division of Physical Medicine and Rehabilitation, University of Utah Health, Salt Lake City, UT.

出版信息

Arch Rehabil Res Clin Transl. 2023 Mar 12;5(2):100264. doi: 10.1016/j.arrct.2023.100264. eCollection 2023 Jun.

DOI:10.1016/j.arrct.2023.100264
PMID:37312977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10258372/
Abstract

OBJECTIVE

To determine the role of multiple factors on general well-being for upper limb prosthesis users.

DESIGN

Retrospective cross-sectional observational design.

SETTING

Prosthetic clinics across the United States.

PARTICIPANTS

At the time of analysis, the database consisted of 250 patients with unilateral upper limb amputation seen between July 2016 and July 2021.

INTERVENTION

Not applicable.

MAIN OUTCOMES MEASURES

Dependent variable: well-being (Prosthesis Evaluation Questionnaire- Well-Being). Independent variables included in analysis: activity and participation (Patient Reported Outcomes Measurement Information System [PROMIS] Ability to Participate in Social Roles and Activities), bimanual function (PROMIS-9 UE), prosthesis satisfaction (Trinity Amputation and Prosthesis Experience Scales-Revised; TAPES-R), PROMIS pain interference, age, gender, average daily hours worn, time since amputation, and amputation level.

RESULTS

A multivariate linear regression model using a forward enter method was applied. The model included 1 dependent variable (well-being) and 9 independent variables. Within the multiple linear regression model, the strongest predictors of well-being were activity and participation (β=0.303, <.0001), followed by prosthesis satisfaction (β=0.257, <.0001), pain interference (β=-0.187, =.001), and bimanual function (β=0.182, =.004). Age (β=-0.036, =.458), gender (β=-0.051, =.295), time since amputation (β=0.031, =.530), amputation level (β=0.042, =.385), and hours worn (β=-0.025, =.632) were not significant predictors of well-being.

CONCLUSION

Reducing pain interference and improving clinical factors such as prosthesis satisfaction and bimanual function with their associated effects on activity and participation will positively affect the well-being of individuals living with upper limb amputation/congenital deficiency.

摘要

目的

确定多种因素对上肢假肢使用者总体幸福感的作用。

设计

回顾性横断面观察设计。

地点

美国各地的假肢诊所。

参与者

在分析时,数据库包含2016年7月至2021年7月期间就诊的250名单侧上肢截肢患者。

干预措施

不适用。

主要结局指标

因变量:幸福感(假肢评估问卷-幸福感)。分析中纳入的自变量:活动与参与(患者报告结局测量信息系统[PROMIS]参与社会角色和活动的能力)、双手功能(PROMIS-9上肢)、假肢满意度(三一截肢与假肢体验量表修订版;TAPES-R)、PROMIS疼痛干扰、年龄、性别、平均每日佩戴时长、截肢后时间以及截肢水平。

结果

应用了采用向前进入法的多元线性回归模型。该模型包含1个因变量(幸福感)和9个自变量。在多元线性回归模型中,幸福感的最强预测因素是活动与参与(β=0.303,P<.0001),其次是假肢满意度(β=0.257,P<.0001)、疼痛干扰(β=-0.187,P=.001)和双手功能(β=0.182,P=.004)。年龄(β=-0.036,P=.458)、性别(β=-0.051,P=.295)、截肢后时间(β=0.031,P=.530)、截肢水平(β=0.042,P=.385)和佩戴时长(β=-0.025,P=.632)并非幸福感的显著预测因素。

结论

减轻疼痛干扰并改善诸如假肢满意度和双手功能等临床因素及其对活动与参与的相关影响,将对上肢截肢/先天性缺陷患者的幸福感产生积极影响。

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