Candice Golembo, Matthew W. Kirkhart, Ph.D., Jen L. Lowry, Ph.D., Jeffrey M. Lating, Ph.D.
Promoting Amputee Life Skills: Outcomes of an Online Interactive Program for Improving Quality of Life Following Limb Loss
In 2005 in the United States, an estimated 1.6 million individuals were living with
the loss of a limb (Ziegler-Graham et al., 2008), with this number being projected
to more than double by the year of 2050 to 3.5 million individuals. Limb loss has
the potential to be an all-encompassing life altering experience. The impact of limb
loss on physical, social, and psychological well-being can be both broad and difficult
for many to overcome. Limitations due to bodily function and structure may hinder
physical activity levels and participation in everyday activities (Gallagher & MacLachlan,
2000a). Individuals with limb loss may face significant changes to their social roles,
intimate relationships, and occupation (Gallagher & MacLachlan, 2000a; Senra et al.,
2011), and depression, anxiety, and frustration are often reported by individuals
within this population (Akyol et al., 2013; Horgan & Maclachlan 2004; Oliveir & Fragoso,
2006; Senra et al., 2011; Stutts et al., 2015). Thus, limb loss may pose a serious
threat to an individual’s psychological health, and overall quality of life. Yet,
there appears to be a dearth of mental health outcomes-based research studies regarding
the treatment of individuals with limb loss, with the bulk of treatment recommendations
never being subjected to empirical review (Yuen, 2017).
There are a number of challenges associated with developing interventions for those
with limb loss. The diversity of experiences related to limb loss makes it difficult
to collect meta-analytic data on psychosocial outcomes among this population (Sinha
& Van Den Heuvel, 2011).
Additionally, this unique population may also face several barriers related to access
to care. These barriers can include physical limitations, limited healthcare coverage,
excessive medical costs, and decreased feelings of self-efficacy (Associated Press,
2013; Gallagher & MacLachlan, 2000a; Senra et al., 2011; Yuen, 2017).
Therefore, it is imperative that those in the field devise efficacious psychotherapeutic
interventions for this population that are ideally home-based and financially feasible.
One type of intervention that is both home-based and financially feasible is web-based
interventions. Web-based interventions serve as ideal options because they allow for
online participation at a financial cost that is not overly burdensome for most. Web-based
interventions are increasingly used in various disease settings to enhance patient
empowerment (Kuijpers et al., 2013), and most importantly, they appear to be effective
in alleviating a variety of mental and physical health difficulties (Kiropoulos et
al., 2008; Kuijpers et al., 2013). Additionally, with the advent of COVID-19, clinicians
and patients alike have come to realize the full potential and benefit of these digital
treatment options (Torous et al., 2020).
The present study aims to address the paucity of research in this area. Promising
results from a community-based Promoting Amputee Life Skills (PALS) program prompted
the development of a pilot online PALS program. The efficacy of PALS Online, an interactive
self-management program that allows participants to work through modules that target
common psychological challenges associated with limb loss, will be examined.