title: Factors associated with vocational reintegration among the Thai lower limb amputees.
abstract: BACKGROUND
  Vocational reintegration is an important goal in the rehabilitation process. The amputees had to take time to adjust themselves to their new condition after lower limb amputation and that might have an impact on their vocation. As yet, there has been no information regarding vocational reintegration among the lower limb amputees in Thailand.
  
  
  OBJECTIVE
  To study the rate of vocational reintegration, factors associated with vocational reintegration among the lower limb amputees.
  
  
  METHODS
  The postal survey with the questionnaires to 1,300 amputees who received the lower limb prostheses between 2001 and 2005 was conducted. The participants were divided into two groups namely the employed and unemployed groups. The Chi-Square and the Independent Sample T Test were used to compare the difference between the two groups. The multiple variables analysis by stepwise logistic regression was used to determine the associated factors.
  
  
  RESULTS
  Three hundred and nine questionnaires were completed among 321 returned questionnaires (response rate 24.7%). Two hundred and forty seven males and 62 females with age ranging from 18-82 years old participated. The rate of vocational reintegration was 66.7%. Demographically, the employed group had less diabetes mellitus (p = 0.001), higher educational level (p = 0.004), were younger at the time of amputation (p < 0.001) and etiologies of amputation were blast injury from mines and congenital problems (p = 0.005). Prosthetic use and problems: the employed group used no gait aids (p < 0.001), had satisfactory to good wearing comfort (p = 0.005), wore prostheses longer hours per day (p < 0.001). The factors associated with vocational reintegration were etiologies of amputation from the blast injury from mines and congenital problems (OR 3.3), educational level from secondary school (OR 2.3), at least satisfactory to good wearing comfort (OR 1.16), and younger at the time of amputation (OR 0.97) respectively.
  
  
  CONCLUSIONS
  This information can assist the rehabilitation personnel to encourage the vocational reintegration among the Thai lower limb amputees.
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. siptb@mahidol.ac.th
authors.forename: Piyapat
authors.initials: P
authors.lastname: Dajpratham
authors.forename: Suchat
authors.initials: S
authors.lastname: Tantiniramai
authors.forename: Pranee
authors.initials: P
authors.lastname: Lukkapichonchut
authors.forename: Siriluck
authors.initials: S
authors.lastname: Kaewnaree
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006306:Health Surveys; D006801:Humans; D035002:Lower Extremity / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012050:Rehabilitation, Vocational; D011795:Surveys and Questionnaires; D013785:Thailand