Quality of Relationships With Caregivers, Depression, and Life Satisfaction After Dysvascular Lower Extremity Amputation

Arch Phys Med Rehabil. 2018 Mar;99(3):452-458. doi: 10.1016/j.apmr.2017.09.110. Epub 2017 Oct 5.


Objective: To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA).

Design: Cross-sectional cohort study using self-report surveys.

Setting: Department of Veterans Affairs, academic medical center, and level I trauma center.

Participants: Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men).

Interventions: Not applicable.

Main outcome measures: The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction.

Results: In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms.

Conclusions: The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict.

Keywords: Amputation; Caregivers; Depression; Rehabilitation; Social support.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / psychology
  • Amputees / psychology*
  • Caregivers / psychology*
  • Cross-Sectional Studies
  • Depression / psychology*
  • Diabetes Complications / surgery
  • Female
  • Humans
  • Interpersonal Relations*
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / surgery
  • Personal Satisfaction*
  • Postoperative Period
  • Prospective Studies
  • Self Report
  • Veterans / psychology