title: Satisfaction with cosmesis and priorities for cosmesis design reported by lower limb amputees in the United Kingdom: instrument development and results.
abstract: BACKGROUND
  Amputee satisfaction with cosmesis and the importance they place on cosmesis design have not been published in the literature.
  
  
  OBJECTIVE
  To investigate the current satisfaction levels of amputees in the United Kingdom with their cosmesis and the importance placed on attributes of cosmesis design to inform future cosmesis redesign.
  
  
  METHODS
  Cross-sectional questionnaire study.
  
  
  METHODS
  Questionnaires were administered to lower limb amputees in the United Kingdom. Satisfaction scores and the overall importance ranking of cosmesis features were calculated. Statistically significant relationships between two demographic, satisfaction or importance variables were tested using Fisher's exact tests (one-tailed) at a significance level p = 0.05.
  
  
  RESULTS
  Between 49% and 64% of respondents reported neutral or dissatisfied opinions with the cosmesis features (greater than 50% for five of the nine features). The three most important features identified were shape matching the cosmesis to the sound limb, free prosthetic joint movement underneath the cosmesis and natural fit of clothing over the cosmesis.
  
  
  CONCLUSIONS
  The results indicate that current cosmesis satisfaction levels of amputees in the United Kingdom are below what the medical device industry and clinical community would desire. The most important cosmesis features identified by the sample can be used to direct future cosmesis design research.
  
  
  CONCLUSIONS
  The findings will enable the medical device industry to improve cosmesis design in the areas that are important to amputees. The findings also counter anecdotal opinions held by clinicians, providing an opportunity for them to evaluate any preconceptions they harbour and how this might influence their clinical work.
authors: Department of Design, Manufacture and Engineering Management, University of Strathclyde, Glasgow, UK National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK nicola.j.cairns@strath.ac.uk.
authors: Nicola
authors: N
authors: Cairns
authors: National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
authors: Kevin
authors: K
authors: Murray
authors: Department of Design, Manufacture and Engineering Management, University of Strathclyde, Glasgow, UK.
authors: Jonathan
authors: J
authors: Corney
authors: AKM-STATs, Statistical Consultant, Glasgow, UK.
authors: Angus
authors: A
authors: McFadyen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012656:Self-Help Devices / Q000639:trends*; D013518:Surgery, Plastic / Q000379:methods*; D011795:Surveys and Questionnaires; D013977:Tibia / Q000601:surgery; D006113:United Kingdom; D055815:Young Adult
keywords: Amputation; cosmesis; importance; lower limb; prosthetic design; questionnaire; satisfaction; transfemoral; transtibial