Qualitative analysis of resilience characteristics of people with unilateral transtibial amputation

Matthew J Miller; Meredith L Mealer; Paul F Cook; Noel So; Megan A Morris; Cory L Christiansen

doi:10.1016/j.dhjo.2020.100925

Qualitative analysis of resilience characteristics of people with unilateral transtibial amputation

Disabil Health J. 2020 Oct;13(4):100925. doi: 10.1016/j.dhjo.2020.100925. Epub 2020 Apr 8.

Authors

Matthew J Miller¹, Meredith L Mealer², Paul F Cook³, Noel So⁴, Megan A Morris⁵, Cory L Christiansen⁶

Affiliations

¹ Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA; Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA. Electronic address: matthew.miller4@ucsf.edu.
² Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA; Mental Illness Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO, USA.
³ College of Nursing, University of Colorado, Aurora, CO, USA.
⁴ Department of Physical Medicine and Rehabilitation, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.
⁵ Adult and Child Consortium of Research and Delivery Science, University of Colorado, Aurora, CO, USA.
⁶ Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO, USA.

Abstract

Background: Resilience characteristics are a significant factor in the highly variable rehabilitation outcomes for people in middle age or later with transtibial amputation.

Objective: The purpose of this study was to describe resilience characteristics meaningful to people with transtibial amputation in middle age or later, who use a prosthesis.

Methods: Semi-structured interviews were conducted, audio recorded, and transcribed with eighteen participants. Interview transcripts were coded and analyzed using a directed content analysis approach, guided by Charney's theory of resilience and Connor-Davidson Resilience Scale scores.

Results: Five main resilience characteristics (themes) were identified: coping skills, cognitive flexibility, optimism, skill for facing fear, and social support. Participants with higher resilience scores generally described effective use of coping skills, cognitive flexibility, optimism, skills in facing fears, and social support to attain meaningful goals. In contrast, participants with lower resilience scores discussed passive coping strategies, cognitive rigidity, general pessimism, avoidance of activities due to fear, or social support limitations.

Conclusion: Coping skills, cognitive flexibility, optimism, skills for facing fear, and social support were identified as meaningful resilience characteristics for people with transtibial amputation in middle age or later. These characteristics can be targeted and enhanced using resilience interventions. Future research should consider these characteristics when designing and testing rehabilitation focused resilience interventions for people with TTA.

Keywords: Coping; Lower extremity amputation; Psychosocial; Qualitative; Resilience.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adaptation, Psychological*
Aged
Amputation, Surgical / psychology*
Amputation, Surgical / statistics & numerical data*
Artificial Limbs / psychology*
Artificial Limbs / statistics & numerical data
Disabled Persons / psychology*
Disabled Persons / statistics & numerical data*
Evaluation Studies as Topic
Female
Humans
Male
Middle Aged
Resilience, Psychological*

Abstract

Publication types

MeSH terms

Grants and funding