# Factors influencing the health-related quality of life among persons with lower limb amputation wearing a prosthesis

## TL;DR

This study examines how sociodemographic and disability-related factors affect the quality of life for people with lower limb amputation who use prostheses.

## Contribution

The study identifies specific factors influencing HRQoL and their relationships with body image and self-esteem in prosthesis users.

## Key findings

- Younger age, higher education, and unemployment or being a student correlate with better HRQoL.
- Self-esteem positively correlates with HRQoL, while body image disturbance negatively correlates with it.
- Amputation due to accidents is associated with better HRQoL than amputation due to Type 2 diabetes.

## Abstract

Limb amputation is often an unavoidable process in many diseases and accidents, leading to several limitations in social, professional, and recreational activities.

To explore the perceptions of persons with lower limb amputation (PLLA) wearing a prosthesis regarding the health-related quality of life (HRQoL), and to examine the relationships between HRQoL, body image disturbance, and self-esteem.

The research sample consisted of 91 PLLA who were using a prosthesis. The data were collected through a questionnaire comprised of demographic information and the following scales: The Short Form Health Survey-12 (SF-12), the Amputee Body Image Scale (ABIS-R), and the Rosenberg scale (RSES), in order to assess HRQoL, body image disturbance, and self-esteem respectively. The SPSS statistical software (v.26) was used for the statistical analysis of the data.

The mean SF-12 score of the participants was 70.31 (SD=16.74). The HRQoL was affected by the following sociodemographic factors: age, educational level, profession, income, marital status, and parenthood. It was also influenced by disability-related factors, such as amputation cause and years of prosthesis use. In particular, young participants reported a better level of HRQoL than the older participants (p<0.001). Participants with a higher education level presented better HRQoL than those with lower education level (p<0.001). Unemployed participants and students presented better HRQoL scores compared to all other professional categories (p=0.001). However, participants with lower incomes <10,000 € reported a lower level of HRQoL (p=0.028). Singles had the highest HRQoL score, while widowers had the lowest (p=0.001). Childfree participants experienced the highest level of HRQoL (p=0.001). Participants whose amputation resulted from an accident reported a better HRQoL compared to those who had an amputation due to Type 2 diabetes (p<0.001). As the years of prosthesis use increase, HRQoL decreases (p=0.001). Regarding the associations between HRQoL, body image disturbance, and self-esteem statistically significant relationships were recorded. More specifically, there is a significant positive relationship between RSES and SF-12 (p<0.001); as participants’ self-esteem increases, so does their HRQoL. Conversely, a statistically significant negative correlation emerged between SF-12 and ABIS-R (p<0.001); as HRQoL increases, body image disturbance decreases.

The aforementioned factors should be considered in the design and implementation of psychosocial interventions aimed at recovery. Qualitative studies are recommended to explore the lived experiences of PLLA in-depth.

None Declared