Patients who require amputation rehabilitation due to severe traumatic
amputations are usually, but not always, young and healthy, heal rapidly and are physically able to participate in a vigorous rehabilitation program. Because of the amputation is the resulting effect of a severely incapacitating injury, the individual not only needs physical support and care but more importantly psychological support in accepting the sudden changes in the body image and in dealing with the stresses of hospitalization, long term rehabilitation and modification of lifestyle.
Individuals who undergo an amputation procedure and are due for amputation rehabilitation need all the support they need as they grieve the loss, and they need time to work through their feelings about their permanent loss and change in body image. Their reactions are usually denial, anger, bitterness, hostility, hopelessness which can manifest in depressive or violent behavior bring about by a disturbance in their body image.
Multidisciplinary approach in amputation rehabilitation
The multidisciplinary team (nurse, physician, social worker, physical therapist, occupational therapist, psychologist, prosthestist, vocational rehabilitation worker) who all have a responsibility in the amputation rehabilitation of the patient is tasked with assisting the patient achieve the highest possible level of function and participation in activities of daily living. Prosthetic clinics and amputee support groups facilitate this rehabilitation process. Vocational counseling and job restraining may be necessary to assist patients return to their normal work activities and daily routines.
Psychological effects during amputation rehabilitation
Many frustrating and depressive emotions can accompany the experience of surgical amputation throughout recovery and amputation recovery activities. Moreover, heralding such burden of emotions can lead to anger and dysfunctional coping along with the psychological impact on the amputee as much as it already heavily impacted an individual’s self perception of his/her body image. Psychological issues such as denial and withdrawal may be influenced by the type of support the patient may influenced by the type of support and by how quickly activities of daily living and the use of prosthesis are learned. Knowing the full options and capabilities available with the various prosthetic devices can give the patient a sense of control over the resulting disability.
Assessing a patient undergoing amputation rehabilitation
The nurse, in general is tasked with assessing the patient’s psychological status. Determination of the patient’s emotional reaction to amputation and resulting disability is very vital for effective nursing care management following the surgical procedure of amputating a body part. Grief responses to permanent alterations of body image, function, and mobility are a normal aspect of emotional recovery from an amputation. An adequate support system and professional counseling can effectively help the patient cope with the aftermath of amputation surgery.
The process of adjusting to work-related amputation often include ongoing emotional, psychological and behavioral adaptations. All occupational related amputations can evoke a wide and complex range of emotional and psychological reactions especially during the post recovery stages of the rehabilitation process. Work related injury that led to amputation has a high incidence of severe psychological stress including post traumatic stress symptoms, depression, grief, body image disturbance and hopelessness. The nurse along with the multidisciplinary team charged with the care of individuals with amputations should be prepared to experience the accompanying distress in amputation rehabilitation including anger and hostility manifested by the amputee. As advocates and health professionals they should be empathetic in providing support and understanding towards their patients’ recovery.