title: A prospective study of positive adjustment to lower limb amputation.
abstract: OBJECTIVE
  To examine prospectively the influence of demographic, amputation and psychosocial variables on positive psychological adjustment outcomes for lower limb amputees.
  
  
  METHODS
  A quantitative questionnaire study with two time points: at the beginning of rehabilitation and at six-month follow-up. Multiple regression analyses were used to determine the contribution of demographic/amputation factors versus psychosocial factors to adjustment outcomes.
  
  
  METHODS
  A regional outpatient specialist mobility and rehabilitation centre in the UK.
  
  
  METHODS
  Participants were recruited as a consecutive sample of new referrals with lower limb amputation.
  
  
  METHODS
  Age, gender, level and cause of amputation were recorded. The following measures were used: Hope Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Trinity Amputation and Prosthetic Experiences Scale (TAPES) pain subscale initially and the Positive and Negative Affect Scale (PANAS) and full TAPES at six-month follow up. The measures were administered by two specialist nurses.
  
  
  RESULTS
  Ninety-nine patients provided data at both time points. Hope at the beginning of rehabilitation was related to positive mood (P<0.001) and hope and social support were related to general adjustment (P<0.01, P<0.001) at follow-up. Demographic and amputation factors were not related to psychological adjustment outcomes in this study.
  
  
  CONCLUSIONS
  The findings demonstrate prospectively the importance of psychosocial variables in the prediction of positive adjustment to lower limb amputation.
authors.affiliation: Division of Clinical Psychology, Whelan Building, University of Liverpool, Liverpool L69 3GB, UK. J.unwin@liverpool.ac.uk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Unwin
authors.forename: Lynn
authors.initials: L
authors.lastname: Kacperek
authors.forename: Chris
authors.initials: C
authors.lastname: Clarke
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation; D000674:Amputees / Q000523:psychology; D001294:Attitude to Health; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012944:Social Support; D055815:Young Adult