title: The role of expectations in pain after dysvascular lower extremity amputation.
abstract: OBJECTIVE
  The objective was to determine the relationship between pain expectations assessed prior to surgery and satisfaction with pain 4 and 12 months after major dysvascular lower extremity amputation.
  
  
  METHODS
  The study included a prospective cohort of male (n = 19) veterans experiencing their first lower extremity amputation due to complications of diabetes mellitus or peripheral arterial disease. Measures included presurgical expectations of pain at 4 and 12 months postamputation, actual average pain and satisfaction with pain at 4 and 12 months postamputation, and agreement between expected and actual pain.
  
  
  RESULTS
  Sixty-eight percent of participants expected to experience no or minimal pain at 4 months; 95% expected to experience no or minimal pain at 12 months. Thirty-two percent and 58% of participants had more pain than they expected at 4 and 12 months, respectively. Participants whose pain expectations were met reported higher satisfaction with their actual level of pain at 12 months postamputation, even after adjusting for current pain levels.
  
  
  CONCLUSIONS
  The results underscore the potential value of fostering realistic expectations about the degree to which amputation may impact average pain.
authors.affiliation: Center for Polytrauma Care/Rehabilitation Care Service.
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Williams
authors.affiliation: Rehabilitation Care Service.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.affiliation: Spectrum Research, Inc.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Norvell
authors.affiliation: VA Research Center of Excellence for Limb Loss Prevention and Prosthetic Engineering.
authors.forename: Alison W
authors.initials: AW
authors.lastname: Henderson
authors.affiliation: Rehabilitation Care Service.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Hakimi
authors.affiliation: Rehabilitation Care Service/VA Research Center of Excellence for Limb Loss and Prosthetic Engineering.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Czerniecki
mesh_terms: D000671:Amputation, Surgical / Q000523:psychology* / Q000706:statistics & numerical data; D003925:Diabetic Angiopathies / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D011446:Prospective Studies; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data