Title

Health care responses to meet the need of patients with lower limb amputation at a tertiary care hospital: A qualitative descriptive study

Date of Award

2019

Document Type

Thesis

Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)

Department

Community Health Sciences

Abstract

Adjustment to lower limb amputation encompasses a variety of psychosocial and physical challenges including limitation in physical functioning, pain, discomfort, and change in occupation status, body image, and self-esteem. These stimuli could challenge the amputees' capability to preserve emotional well-being and might encourage inappropriate responses driving to poor psychosocial adaptation. All these changes in an amputee's lives present various difficulties. Their needs are therefore more centered on safety, physiological and psychosocial assistance and are not just confined not to food, drinking water or shelter like an ordinary man. Moreover, it is substantial to explore how healthcare providers at the tertiary care level are responding to the needs of the amputees for improving patient's quality of life. Study objectives; The study aimed to explore the needs of the patients who have undergone lower limb amputation and also to explore the recommendations suggested by the health care providers and amputees. Methodology: It was a qualitative exploratory design. The study was conducted at The Aga Khan University Hospital surgical unit. The study participants were health care providers including doctors, nurses and physiotherapist and also patients who have undergone lower limb amputation. The purposive sampling technique was used for both the participants. The data collection was done using in-depth interviews and focus group discussions. The in-depth interview was conducted from the patients using unstructured questions and the focus group discussions with the healthcare providers. The data was transcribed and themes were developed by manual analysis. Results: Five themes were emerged from the interviews: Physiological needs, safety needs, social needs, psychological needs, and barriers and challenges in availing of the services. These results supported the theoretical framework of Maslow's hierarchy of needs. Amputation has a serious impact on the patient's physical, psychosocial, psychological and financial needs. Amputation of a lower limb creates multiple physical, psychological and psychosocial challenges including changes in physical functioning, low body image, lifestyle changes, and pain. Amputees need close attention from the health care providers to monitor s ymptoms of anxiety and depression and seek consultation from the psychotherapist and psychologist for the proper treatment of the patient. Moreover, the policymakers must address the long term rehabilitation and community restoration of amputees

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