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.


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 / psychology*
  • Amputation / 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*