Adjustment to amputation and psychological distress: an examination of the intervening role of posttraumatic stress and posttraumatic growth

Successful adjustment to amputation can be quantified in a number of ways. Physical measures such as prosthesis use, mobility indices, and activities of daily living have traditionally been suggested as outcome measures in the literature. More recently, the importance of psychological outcomes is gaining attention. This study was based in a regional prosthetic, orthotic, and limb-absence rehabilitation unit. It was developed in order to provide an overview of a range of issues affecting patients, in a multidisciplinary setting. Sixty-two participants completed self-report questionnaires on a range of constructs while attending the unit. From this general study, a central study evolved looking specifically at the relationship between adjustment to amputation and psychological distress, and the possibility of a moderating and/or mediating effect of posttraumatic stress and posttraumatic growth on this relationship. Significant relationships between adjustment to amputation and psychological distress were found. No moderating effect of PTS or PTG was found on the relationship between adjustment to amputation and psychological distress; however, a mediating effect of PTS was apparent. These findings indicate the importance of assessing for PTS symptoms in addition to other psychological issues in people who have undergone amputation, and highlight the need for measures of successful adjustment to amputation to include those of a psychological nature. Learning experiences and suggestions for future research are also discussed.