Resnik Linda, Roberts Anthony I, Borgia Matthew
Research Department, Providence VA Medical Center, Providence, Rhode Island, USA.
Health Services, Policy and Practice, Brown University, Providence, Rhode Island, USA.
PM R. 2025 Apr;17(4):384-395. doi: 10.1002/pmrj.13275. Epub 2024 Nov 4.
Prior research found that Black veterans with upper limb amputation (ULA) reported greater disability and need for assistance compared to White veterans. The extent to which racial disparities in outcomes exist outside of the Department of Veterans Affairs has not been explored.
To examine racial disparities in physical function and prosthesis satisfaction among individuals with ULA and assess the potential moderating role of veteran status.
Cross-sectional survey.
Community-dwelling participants.
U.S. veterans and civilians with ULA.
Not applicable.
Physical function measures included Patient-Reported Outcomes Measurement Information System-Upper Extremity Amputation-specific (PROMIS-UE AMP), and Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) for one-handed and two-handed tasks. Prosthesis satisfaction measures included the modified Client Satisfaction with Device (CSD) Comfort, Appearance, and Utility scales, the CSD-8, and the Trinity Amputation and Prosthesis Experience Satisfaction (TAPES) scale.
Of 713 participants, 79% were male, with mean age of 61.3 years. The racial composition was 83.6% White, 9.1% Black, and 7.3% other, with 75.4% identifying as veterans. Multivariable linear regression found that Black participants (compared to White) had lower PROMIS 13-UE AMP (β: -5.1, 95% CI: -7.7 to -2.5) and UEFS-P Two-Handed Task Scale (β: -4.0, 95% CI: -7.3 to -2.1) scores. Satisfaction scores were lower for Black participants as measured by modified CSD Comfort (β: -3.9, 95% CI: -7.2 to -0.6), Appearance (β: -4.4, 95% CI: -7.5 to -1.2), Utility (β: -3.9, 95% CI: -7.2 to -0.6), and CSD-8 (β: -3.9, 95% CI: -7.2 to -0.6) scales. Veteran status moderated the impact of Black race on the UEFS-P Two-Handed Task Scale and the TAPES.
Black individuals with ULA had worse physical function and prosthesis satisfaction than White individuals. Although veteran status moderated these disparities, the reasons for these disparities remain unclear. Further research is essential to understand the causes of these disparities.
先前的研究发现，与白人退伍军人相比，上肢截肢（ULA）的黑人退伍军人报告的残疾程度更高且更需要帮助。退伍军人事务部以外的结果中种族差异的程度尚未得到探讨。
研究上肢截肢患者身体功能和假肢满意度方面的种族差异，并评估退伍军人身份的潜在调节作用。
横断面调查。
社区居住参与者。
美国上肢截肢的退伍军人和平民。
不适用。
身体功能指标包括患者报告结局测量信息系统-上肢截肢特异性（PROMIS-UE AMP），以及针对单手和双手任务的上肢假肢使用者功能量表（UEFS-P）。假肢满意度指标包括改良的客户对设备满意度（CSD）舒适度、外观和实用性量表、CSD-8以及三位一体截肢与假肢体验满意度（TAPES）量表。
在713名参与者中，79%为男性，平均年龄61.3岁。种族构成是83.6%为白人，9.1%为黑人，7.3%为其他种族，75.4%的人认定为退伍军人。多变量线性回归发现，黑人参与者（与白人相比）的PROMIS 13-UE AMP得分较低（β：-5.1，95%置信区间：-7.7至-2.5），双手任务量表UEFS-P得分也较低（β：-4.0，95%置信区间：-7.3至-2.1）。根据改良的CSD舒适度（β：-3.9，95%置信区间：-7.2至-0.6）、外观（β：-4.4，95%置信区间：-7.5至-1.2）、实用性（β：-3.9，95%置信区间：-7.2至-0.6）和CSD-8（β：-3.9，95%置信区间：-7.2至-0.6）量表测量，黑人参与者的满意度得分较低。退伍军人身份调节了黑人种族对UEFS-P双手任务量表和TAPES的影响。
上肢截肢的黑人身体功能和假肢满意度比白人差。尽管退伍军人身份调节了这些差异，但这些差异的原因仍不清楚。进一步的研究对于理解这些差异的原因至关重要。
