Psychological predictors of quality of life after lower limb amputation

Relevance and Objective. The existing problem of patients’ with chronic diseases adaptation to the disease and surgical treatment and the psychological effects of an amputation remain relevant even now, when methods of organ-preserving treatment are being actively developed. The authors defined the aim of the study: to investigate the quality of life (QoL) of patients suffering from severe chronic diseases and undergoing lower limb amputation (LLA), and to identify clinical and psychological factors determining it.

Material and methods. Thirty-nine patients who underwent LLA due to oncological (61.5 %) and non-oncological (38.5 %) diseases were examined. Clinical diagnostic scales and psychometric tools were used: the questionnaires “Ways of Coping Questionnaire” (WCQ), “Big Five Inventory” (BFI), “Purpose in Life Test” (PIL) and methods of assessment of health-related QOL – “Specialised Quality of Life Questionnaire” (QLQ-C30) and its modules “Fatigue” (FA12) and “Spiritual Wellbeing” (SWB32).

Results. The overall satisfaction with QoL after LLA largely depends on the patient’s assessment of the time perspective, which is associated with meaning and purpose in life (“Life Satisfaction” scale of the PIL, p = 0.001). When assessing the influence of individual parameters of QoL on its overall level, it was found that overall QoL after LLA depends on the severity of the functional state, characterized by the “Impact on Daily Life” scale (FA12 module, p = 0.000): the more pronounced mental and physical exhaustion and the more they limit the patients’ daily functioning, the lower they assess QoL in general.

Conclusion. Among all the studied psychological and clinical characteristics, the greatest contribution to health-related QoL is made by the degree of satisfaction with the passed period of life and the state of fatigue, the degree of asthenic symptoms, which affect the patients’ functioning. Psychological support aimed at self-acceptance, acquiring new meanings of life, as well as the development of energy-saving skills to combat increased fatigue is recommended for patients of this contingent.

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