A prospective study of the importance of life goal characteristics and goal adjustment capacities in longer term psychosocial adjustment to lower limb amputation

摘要

Objective: To explore the life goal characteristics and goal adjustment capacities of persons with lower limb amputation on admission to rehabilitation, and to examine their efficacy as predictors of psychosocial outcomes six months post discharge. Design: Prospective, descriptive. Setting: Two specialist inpatient rehabilitation facilities in Ireland. Subjects: A consecutive sample of 64 patients with lower limb amputation. Main measures: On admission to rehabilitation, life goal characteristics (goal importance, goal disturbance) were assessed using the Goal Facilitation Index and goal adjustment capacities (goal disengagement, goal re-engagement) were measured using the Goal Adjustment Scale. The Beck Depression Inventory-II and the Trinity Amputation and Prosthesis Experience Scales-Revised assessed depressive symptomatology and psychosocial adjustment to amputation at six months post discharge. Results: The highest average importance ratings were assigned to goals associated with interpersonal relationships, independence and subjective well-being. Goals related to physical limitations and disruptions in daily activities received the highest hindrance ratings. Goal importance (β = -0.33) and goal disengagement (β = -0.29) on admission significantly predicted depressive symptomatology six months post discharge (P ≤ 0.05). Goal importance (β = 0.32), goal disturbance (β = -0.26), and goal reengagement (β = -0.21) on admission significantly predicted general adjustment to lower limb amputation at six months post discharge (P ≤ 0.05), while goal importance (β = -0.32) and goal disturbance (β = 0.30) significantly predicted social adjustment (P ≤ 0.05). Conclusions: Life goal characteristics and goal adjustment capacities on admission to rehabilitation predicted psychosocial outcomes six months post discharge among individuals with lower limb amputation.