Parey Bephyer, Varachhia Saleem, Enightoola Hannah, Kutscher Elisabeth
Sir Arthur Lewis Institute of Social and Economic Studies, The University of the West Indies, St. Augustine, Trinidad and Tobago.
Department of Clinical Surgical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
PLOS Glob Public Health. 2025 Jun 18;5(6):e0004739. doi: 10.1371/journal.pgph.0004739. eCollection 2025.
For persons at risk for and experiencing amputations, accessible and cost-effective healthcare plays an essential role in prevention and rehabilitation. In Trinidad and Tobago, amputations continue to rise, despite the national healthcare system's attention to prevention, making the country a relevant case for providing insights into experiences of amputations within a healthcare system. The study used a basic interpretive, qualitative design with interviews conducted with 17 persons with lower-limb amputations and 17 relatives across Trinidad and Tobago. Thematic analysis revealed five themes related to the experiences of persons with amputations and their relatives within the healthcare system: a) care prior to amputation reflected missed opportunities for prevention; b) hospital circumstances compounded participants' experiences; c) post-amputation services hindered rehabilitation and ability of relatives to provide effective care; d) integrated services could promote wellbeing of persons with amputations and their relatives; and e) advocacy is necessary but complicated. Holistic, multidisciplinary care would benefit persons with amputations and their relatives, ultimately reducing burden on the healthcare system by contributing to improved health outcomes and quality of life. Recommendations regarding public health and rehabilitation, including considerations for culturally competent healthcare, are discussed.
对于面临截肢风险以及正在经历截肢的人群而言，可及且具成本效益的医疗保健在预防和康复方面发挥着至关重要的作用。在特立尼达和多巴哥，尽管国家医疗保健系统关注预防工作，但截肢人数仍在不断上升，这使得该国成为一个能为洞察医疗保健系统内截肢经历提供相关见解的典型案例。该研究采用了基本的解释性定性设计，对特立尼达和多巴哥的17名下肢截肢者及17名亲属进行了访谈。主题分析揭示了与截肢者及其亲属在医疗保健系统中的经历相关的五个主题：a）截肢前的护理反映出预防机会的错失；b）医院环境加剧了参与者的经历；c）截肢后服务阻碍了康复以及亲属提供有效护理的能力；d）综合服务可促进截肢者及其亲属的福祉；e）倡导虽有必要但情况复杂。全面的多学科护理将使截肢者及其亲属受益，最终通过改善健康结果和生活质量减轻医疗保健系统的负担。文中还讨论了有关公共卫生和康复的建议，包括对具有文化胜任力的医疗保健的考量。
