Self-Esteem as a Predictor of Psychological Adjustment to Limb Loss: A Case Study of Acquired Limb Amputation
DOI:
https://doi.org/10.37762/jgmds.8-3.196Keywords:
Amputation, Acquired, Psychological, Self-Esteem, Psychosocial, Adjustment, Depression, AnxietyAbstract
OBJECTIVES:
To examine the psychological issues following acquired limb amputation and examine the significance of positive self-esteem in the psychological adjustment of amputation.
METHODOLOGY:
This case study was conducted in the surgical and orthopedic units of different government and private hospitals of Peshawar district. The study includes a sample of 100 acquired limb amputees,both adult males and females admitted in different hospitals of Peshawar. Patients with congenital limb loss or with preexisting psychological issues were excluded from the study. Psychological adjustment scale developed by Sabir (1999) and Self-Esteem scale developed by Rifai’s (1999) was used to determine the amputee’s level of psychological adjustment and self-esteem.
RESULTS:
Results revealed that amputation leads to number of psychological issues. It was found that males had lowered self-esteem and severe adjustment issues then females while young amputees exhibit greater signs of maladjustment as compared to older amputees. Regression analysis for selfesteem predicting psychological adjustment also displayed pronounced differences in the level of psychological adjustment due changing level of self-esteem. The model suggested a strong positive relation between self-esteem and psychological adjustment (r=0.880, B=0.867, t=18.37, p<.001) and 77.5% of the variance in the dependent variable (psychological adjustment) was caused by predictor variable i.e. self-esteem (R2=0.775, F (98)=337.6, p<.001).
CONCLUSION:
Amputation badly disturbs the psychological state of an amputee and an amputee’s self-esteem is an important coping tool and has a direct relation with better psychological adjustment to limb loss.
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Mckechnie PS, John A. Anxiety and depression following traumatic limb amputation: a systematic review. Injury. 2014;45:1859-66 DOI: https://doi.org/10.1016/j.injury.2014.09.015
Bennett J. Limb loss: the unspoken psychological aspect. J Vasc Nurs. 2016;34(4):127-66 DOI: https://doi.org/10.1016/j.jvn.2016.06.001
Sahu A, Sagar R, Sarkar S, Sagar S. Psychological effects of amputation: a review of studies from India. Ind Psychiatry J. 2016;25(1):4-10 DOI: https://doi.org/10.4103/0972-6748.196041
Kearns NT, Jackson WT, Elliott TR, Ryan T, Armstrong TW. Differences in level of upper limb loss on functional impairment, psychological well-being, and substance use. Rehabil Psychol. 2018;63(1):141 DOI: https://doi.org/10.1037/rep0000192
Falgares G, Lo Gioco A, Verrocchio MC, Marchetti D. Anxiety and depression among adult amputees: the role of attachment insecurity, coping strategies and social support. Psychol Health Med. 2019;24(3):281-93 DOI: https://doi.org/10.1080/13548506.2018.1529324
Pedras S, Vilhena E, Carvalho R, Pereira MG. Psychosocial adjustment to a lower limb amputation ten months after surgery. Rehabil Psychol. 2018;63(3):418 DOI: https://doi.org/10.1037/rep0000189
Jauregui JJ, Nadarajah V, Munn J, Pivec R, Kapadia BH, Lerman DM, et al. Limb salvage versus amputation in conventional appendicular osteosarcoma: a systematic review. Indian J Surg Oncol. 2018;9(2):232-40 DOI: https://doi.org/10.1007/s13193-018-0725-y
Kuret Z, Burger H, Vidmar G, Maver T. Adjustment to finger amputation and silicone finger prosthesis use. Disabil Rehabil. 2019;41(11):1307-12 DOI: https://doi.org/10.1080/09638288.2018.1424954
Srivastava K, Saldanha D. A study of psychological correlates after amputation. Med J Armed Forces India. 2010;66(4):367-73 DOI: https://doi.org/10.1016/S0377-1237(10)80021-8
Neil MJ. Pain after amputation. BJA Educ. 2016;16(3):107-12 DOI: https://doi.org/10.1093/bjaed/mkv028
Moxey PW, Gogalniceanu P, Hinchliffe RJ, Loftus IM, Jones KJ, Thompson MM, et al. Lower extremity amputations: a review of global variability in incidence. Diabetic Med. 2011;28(10):1144-53 DOI: https://doi.org/10.1111/j.1464-5491.2011.03279.x
Ajibade A, Akinniyi OT, Okoye CS. Indications and complications of major limb amputations in Kano, Nigeria. Ghana Med J. 2013;47(4):185-8
Sabir F. Psychological adjustment scale [thesis]. Islamabad: National Institute of Psychology, Quaid-i-Azam University; 1999
Rifai F. Development and validation of a self-esteem scale [dissertation]. Islamabad: Quaid-i-Azam University; 1999
Jensen MP, Moore MR, Bockow TB, Ehde DM, Engel JM. Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. Arch Phys Med Rehabil. 2011;92(1):146-60 DOI: https://doi.org/10.1016/j.apmr.2010.09.021
Gil S, Fernandez-Pineda I, Rao B, Neel MD, Baker JN, Wu H, et al. Role of amputation in improving mobility, pain outcomes, and emotional and psychological well-being in children with metastatic osteosarcoma. Am J Hospice Palliative Med. 2019;36(2):105-10 DOI: https://doi.org/10.1177/1049909118791119
Pérez MD, Chines C, García AJ, Sousa D, Fernández FJ, Marcelino-Rodríguez I, et al. Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences. BMC Public Health. 2020;20(1):1-8 DOI: https://doi.org/10.1186/s12889-019-8137-7
Ahmad A, Ashfaq O, Akhtar N, Rana T, Gul M. Causes of lower limb amputation in patients registered at Pakistan institute of prosthetic and orthotic sciences Peshawar-Pakistan. Khyber Med Univ J. 2019;11(1):41-4 DOI: https://doi.org/10.35845/kmuj.2019.18096
Soomro N, Bibi R, Ahmed SI, Kamran B, Minhas MA, Siddiqui KY. Epidemiology of amputation; low resource community: Sindh Province, Pakistan. Prof Med J. 2013;20(2):261-5 DOI: https://doi.org/10.29309/TPMJ/2013.20.02.685
Solgajová A, Sollár T, Vörösová G. Gender, age and proactive coping as predictors of coping in patients with limb amputation. Kontakt. 2015;17(2):67-72 DOI: https://doi.org/10.1016/j.kontakt.2015.01.005
Sarvestani A, Azam AT. Amputation: a ten-year survey. Trauma Mon. 2013;18(3):126-9 DOI: https://doi.org/10.5812/traumamon.11693
Cater JK. Traumatic amputation: psychosocial adjustment of six army women to loss of one or more limbs. J Rehabil Res Dev. 2012;49(10):1443-56 DOI: https://doi.org/10.1682/JRRD.2011.12.0228
Uustal H. In: Lower limb amputation, rehabilitation, and prosthetic restoration. Current Diagnosis and Treatment: Physical Medicine and Rehabilitation. Maitin IB, Cruz E, editors. New York: McGraw-Hill Education; 2015
Muzaffar N, Mansoor I, Hafeez A, Margoob M. Psychiatric comorbidity in amputees with average socio-demographic status and the role of theologic and family support in a conflict zone. Australas J Disaster Trauma Stud. 2012;2012(1):31-8
Washington J. The relations among psychological and demographic factors in individuals with lower limb amputation [thesis]. Hartford, CT: Trinity College; 2013
Pedras S, Carvalho R, Pereira MG. A predictive model of anxiety and depression symptoms after a lower limb amputation. Disabil Health J. 2018;11(1):79-85 DOI: https://doi.org/10.1016/j.dhjo.2017.03.013
Sahu A, Gupta R, Sagar S, Kumar M, Sagar R. A study of psychiatric comorbidity after traumatic limb amputation: a neglected entity. Ind Psychiatry J. 2017;26(2):228. DOI: https://doi.org/10.4103/ipj.ipj_80_16
Herrera-Moreno D, Carvajal-Ovalle D, Cueva-Nuñez MA, Acevedo C, Riveros-Munévar F, Camacho K, et al. Body image, perceived stress, and resilience in military amputees of the internal armed conflict in Colombia. Int J Psychol Res. 2018;11(2):56-62 DOI: https://doi.org/10.21500/20112084.3487
Chang CW, Yuan R, Chen JK. Social support and depression among Chinese adolescents: the mediating roles of self-esteem and self-efficacy. Child Youth Serv Review. 2018;88:128-34 DOI: https://doi.org/10.1016/j.childyouth.2018.03.001
Topcu G, Griffiths H, Bale C, Trigg E, Clarke S, Potter KJ, et al. Psychosocial adjustment to multiple sclerosis diagnosis: a meta-review of systematic reviews. Clin Psychol Rev. 2020;82:101923 DOI: https://doi.org/10.1016/j.cpr.2020.101923
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Copyright (c) 2021 Shaista Ali, Muhammad Waqar, Musarrat Anwar, Muhammad Zahid, Abdul Sattar, Muhammad Arif
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