Use and satisfaction with prosthetic limb devices and related services

Objectives: To examine the use and satisfaction with prosthetic limb devices and satisfaction with prosthetist services in a large and diverse sample of persons with limb loss. Design: Retrospective cohort study. Setting: General community. Participants: Persons aged 18 to 84 years identified from the Amputee Coalition of America registry as having a major upper- or lower-limb loss due to vascular disease, trauma, or malignancy. Interventions: Not applicable. Main Outcome Measures: Use and satisfaction with prosthetic limb devices and satisfaction with prosthetists' services, assessed via structured telephone interviews. Results: Most persons (94.5%) surveyed had a prosthesis and used it extensively (71h/wk). Most persons with amputations appeared to be satisfied with the overall performance of their prostheses (75.7%). Nearly one third of them, however, expressed dissatisfaction with their prostheses' comfort. Frequency of prosthesis use and satisfaction with the device were significantly higher among those with shorter timing to first prosthesis fitting, even after controlling for a wide array of respondents' sociodemographic and amputation characteristics. Overall, persons with amputations in our sample had positive assessments of their prosthetists' quality. Less favorable ratings concerned items related to the prosthetists' interpersonal skills. Multivariate analyses showed that men and black persons with amputations were less likely than their female or white counterparts to have favorable perceptions about their prosthetists across all dimensions of provider quality. Persons with fewer years of schooling were also less likely to be satisfied with their prosthetist's interpersonal manner. There were no significant differences in prosthesis use, satisfaction, or assessment of prosthetists' quality based on amputation etiology or amputation level. Conclusions: Efforts should be directed at minimizing the interval from surgery to first prosthesis fitting and at improving communication between patients and prosthetists, to improve the quality of care provided to the growing numbers of persons with limb loss.