Upper-limb prosthetics: critical factors in device abandonment.
OBJECTIVE
To investigate the roles of predisposing characteristics, established need, and enabling resources in upper-limb prosthesis use and abandonment.


METHODS
A self-administered, anonymous survey was designed to explore these factors. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer. Two hundred forty-two participants of all ages and levels of upper-limb absence completed the survey.


RESULTS
Of participants, 20% had abandoned prosthesis use. Predisposing factors, namely, origin of limb absence, gender, bilateral limb absence, and, most importantly, level of limb absence, proved influential in the decision not to wear prostheses. Enabling resources such as the availability of health care, cost, and quality of training did not weigh heavily on prosthesis rejection, with the exception of the fitting time frame and the involvement of clients in the prosthesis selection. Conversely, the state of available technology was a highly censured factor in abandonment, specifically in the areas of comfort and function. Perceived need emerged as a predominant factor in prosthesis use.


CONCLUSIONS
Future research should focus on continued development of more comfortable and functional prostheses, particularly for individuals with high-level or bilateral limb absence. Improved follow-up, repair, and information services, together with active involvement of clients in the selection of prostheses meeting their specific goals and needs, is recommended.
Biddiss
Elaine
E
Bloorview Research Institute, Toronto, Canada.
Chau
Tom
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001186:Artificial Limbs / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D006804:Ergonomics; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011474:Prosthesis Design; D011787:Quality of Health Care; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data; D034941:Upper Extremity / Q000473:pathology*