title: Environmental barriers experienced by amputees: the Craig Hospital Inventory of Environmental Factors-Short Form.
abstract: OBJECTIVE
  To describe the prevalence of perceived environmental barriers in a population of amputees; to compare and contrast those barriers reported by amputees with reported barriers of a sample of disabled and nondisabled persons; and to identify the correlates of barriers among amputees.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A community sample who were interviewed by telephone.
  
  
  METHODS
  A stratified sample by etiology of 914 community-dwelling persons with limb loss.
  
  
  METHODS
  Telephone interview.
  
  
  METHODS
  Frequency (never, less than monthly, monthly, weekly, daily) and magnitude (little problem, big problem) of perceived environmental barriers in 5 domains as measured by the Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee.
  
  
  RESULTS
  The majority (87%) of persons surveyed reported barriers in 1 or more areas with 57% reporting barriers in 4 or more of the 5 domains (policies, physical/structural, work/school, attitudes/support, and services/assistance subscales). Mean frequency-magnitude scores were lower for amputees with cancer-related amputation across all subscales, while traumatic amputees reported the greatest perceived barriers, except in the area of services/assistance. Across all domains, poverty level and comorbidity were significant predictors of significant barriers (CHIEF-SF score >/=3; range, 0-8). When compared with a general population sample of disabled and nondisabled Americans, amputees were more likely to perceive barrier in all areas except work/school.
  
  
  CONCLUSIONS
  Perceived environmental barriers among persons with limb loss are highly prevalent. Reduction of environmental barriers may lead to reduction of disability and improvement of overall quality of life for amputees.
authors.affiliation: Limb Loss Research and Statistics Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. pephraim@jhsph.edu
authors.forename: Patti L
authors.initials: PL
authors.lastname: Ephraim
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: MacKenzie
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wegener
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Dillingham
authors.forename: Liliana E
authors.initials: LE
authors.lastname: Pezzin
mesh_terms: D000328:Adult; D000368:Aged; D000674:Amputees / Q000523:psychology*; D001107:Architectural Accessibility; D001930:Brain Injuries / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006297:Health Services Accessibility; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D012931:Social Environment; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology