Quality of Life among Lower Limb Amputees with Chronic Phantom Limb Pain or Stump Pain at a Tertiary Institution’s Pain Clinic

Koravee Pasutharnchat¹, Anuch Juengsmarn¹, Juthamas Jarupongsa¹

Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Background: Phantom pain and stump pain in amputees have negative physical and psychological impacts. These effects may influence the quality of life (QoL) of lower limb amputees.
Objective: To explore QoL of lower limb amputees treated at Ramathibodi pain clinic.
Materials and Methods: All lower limb amputees treated at Ramathibodi pain clinic in 2020 were invited to answer questionnaires, including demographic data, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were recruited to join a focus group discussion and individual interviews. Qualitative data were collected, and then analyzed using content analysis and inductive thematic analysis.
Results: Twenty-two participants were recruited. Average SF-36 score was 49.17±10.07. Physical component summary was 23.36±15.27 and mental component summary was 68.02±16.45. HADS were 5.91±3.69 and 5.23±3.42 for anxiety and depression, respectively. Eight participants were selected for focus group discussion and individual interviews. Five themes emerged, including biopsychosocial effects of amputation, pain among amputees, concepts of encouragement in life, gaps between patients and multidisciplinary team staff, and effects of the COVID-19 pandemic.
Conclusion: Lower limb amputees had low QoL. Amputation was found to restrict patients’ physical function, and good pain management wasreported to be crucial to help amputees cope and accept their condition. Positive self-esteem and social support also played a significant role. Inadequate communication was found to be the main deficit requiring attention. Lockdown policies during the COVID-19 pandemic affected QoL but pain intensity was maintained with management via telemedicine.

Received 20 December 2021 | Revised 18 February 2022 | Accepted 22 February 2022
Website: http://www.jmatonline.com

Keywords : Lower limb amputee; Quality of life; Phantom limb pain; Stump pain

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