How do users define success with a lower limb prosthesis? A focus group study

In this study, we sought to examine how lower limb prosthesis users define success, what constructs they associate with success, and what barriers and facilitators contribute to achieving success. Purposively sampled lower limb prosthesis users were recruited to participate in a focus group study. Verbatim transcripts from focus groups were analyzed using inductive thematic analysis. Identified constructs were mapped to existing outcome measures, and a conceptual framework for success with a lower limb prosthesis was proposed. Thirty-one lower limb prosthesis users participated in one of five focus groups. Five themes were developed: keep moving forward, despite ups and downs; being able to live MY normal life and do the things I want to do with ease; learning what works for me and how to manage my prosthesis; only I can define my success; and what about my mental health? Several constructs that do not align with existing measures were identified, including prosthetic attention, grief/loss after amputation, and trust in prosthesis. Facilitators for success described by participants included peer connection, finding the right prosthetist, and mental health support. According to lower limb prosthesis users, success must be patient-driven, individually defined, and continually reassessed. According to prosthesis users, success with a lower limb prosthesis should be patient-driven, individually defined, and continually reassessed.Lower limb prosthesis users described facilitators for success to include peer connection, finding the right prosthetist, mental health support, and access to appropriate prosthetic technology.Constructs described by lower limb prosthesis users as relating to success that are currently difficult to measure include prosthetic attention, grief/loss after amputation, prosthesis management, ability to blend in, and trust in the prosthesis. According to prosthesis users, success with a lower limb prosthesis should be patient-driven, individually defined, and continually reassessed. Lower limb prosthesis users described facilitators for success to include peer connection, finding the right prosthetist, mental health support, and access to appropriate prosthetic technology. Constructs described by lower limb prosthesis users as relating to success that are currently difficult to measure include prosthetic attention, grief/loss after amputation, prosthesis management, ability to blend in, and trust in the prosthesis.

本研究旨在探究下肢假肢（lower limb prosthesis）使用者如何定义成功、其将哪些构念（construct）与成功相关联，以及哪些阻碍因素与促进因素有助于达成成功。本研究采用目的性抽样方法招募下肢假肢使用者参与焦点小组（focus group）研究。研究采用归纳式主题分析法对焦点小组的逐字转录文本进行分析。将识别出的构念映射至现有结局指标，并提出了下肢假肢使用者成功适配的概念框架。共有31名下肢假肢使用者参与了5个焦点小组中的1组。最终提炼出5个主题：纵使历经起伏仍坚持前行；能够自如地过属于自己的常态生活，随心完成所愿之事；摸索出适配自身的方法并学会如何管理假肢；唯有自我方能定义自身的成功；以及心理健康议题。研究识别出若干与现有评估工具不匹配的构念，包括假肢关注度、截肢后悲伤/丧失感以及对假肢的信任。参与者提及的成功促进因素包括同伴联结、找到合适的假肢矫形师以及心理健康支持。下肢假肢使用者认为，成功必须以患者为导向、由个体自主定义，并需持续重新评估。下肢假肢使用者认为，下肢假肢适配成功应当以患者为导向、由个体自主定义，并需持续重新评估。下肢假肢使用者提及的成功促进因素包括同伴联结、找到合适的假肢矫形师、心理健康支持以及获取适宜的假肢技术。下肢假肢使用者提出的与成功相关但目前难以测量的构念包括假肢关注度、截肢后悲伤/丧失感、假肢管理能力、融入环境的能力以及对假肢的信任。下肢假肢使用者认为，下肢假肢适配成功应当以患者为导向、由个体自主定义，并需持续重新评估。下肢假肢使用者提及的成功促进因素包括同伴联结、找到合适的假肢矫形师、心理健康支持以及获取适宜的假肢技术。下肢假肢使用者提出的与成功相关但目前难以测量的构念包括假肢关注度、截肢后悲伤/丧失感、假肢管理能力、融入环境的能力以及对假肢的信任。