Keren Lehavot1,2,3, Jessica P Young4, Rachel M Thomas4, Rhonda M Williams5,6,7, Aaron P Turner5,6,7, Daniel C Norvell6,7, Joseph M Czerniecki6,7, Anna Korpak8, Alyson J Littman4,8,9. 1. Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, WA, USA. keren.lehavot@va.gov. 2. Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA. keren.lehavot@va.gov. 3. Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA. keren.lehavot@va.gov. 4. Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, WA, USA. 5. Rehabilitation Care Service, VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, WA, USA. 6. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. 7. Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, WA, USA. 8. Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, US Department of Veterans Affairs, Seattle, WA, USA. 9. Department of Epidemiology, University of Washington, Seattle, WA, USA.
Abstract
BACKGROUND: Women Veterans with amputation are a group with unique needs whose numbers have grown over the last 5 years, accounting for nearly 3% of all Veterans with amputation in 2019. Although identified as a national priority by the Veterans Health Administration, the needs of this population have remained largely underrepresented in amputation research. OBJECTIVE: To describe the experiences of women Veterans with lower extremity amputation (LEA) related to prosthetic care provision and devices. DESIGN: National qualitative study using semi-structured individual interviews. PARTICIPANTS: Thirty women Veterans with LEA who had been prescribed a prosthesis at least 12 months prior. APPROACH: Inductive content analysis. KEY RESULTS: Four key themes emerged: (1) a sense of "feeling invisible" and lacking a connection with other women Veterans with amputation; (2) the desire for prosthetic devices that meet their biological and social needs; (3) the need for individualized assessment and a prosthetic limb prescription process that is tailored to women Veterans; the current process was often perceived as biased and either dismissive of women's concerns or failing to adequately solicit them; and (4) the desire for prosthetists who listen to and understand women's needs. CONCLUSIONS: Women Veterans with LEA articulated themes reminiscent of those previously reported by male Veterans with LEA, such as the importance of prostheses and the central role of the provider-patient relationship. However, they also articulated unique needs that could translate into specific strategies to improve prosthetic care, such as integrating formal opportunities for social support and peer interaction for women Veterans with LEA, advocating for administrative changes and research efforts to expand available prosthetic component options, and ensuring that clinical interactions are gender-sensitive and free of bias.
BACKGROUND: Women Veterans with amputation are a group with unique needs whose numbers have grown over the last 5 years, accounting for nearly 3% of all Veterans with amputation in 2019. Although identified as a national priority by the Veterans Health Administration, the needs of this population have remained largely underrepresented in amputation research. OBJECTIVE: To describe the experiences of women Veterans with lower extremity amputation (LEA) related to prosthetic care provision and devices. DESIGN: National qualitative study using semi-structured individual interviews. PARTICIPANTS: Thirty women Veterans with LEA who had been prescribed a prosthesis at least 12 months prior. APPROACH: Inductive content analysis. KEY RESULTS: Four key themes emerged: (1) a sense of "feeling invisible" and lacking a connection with other women Veterans with amputation; (2) the desire for prosthetic devices that meet their biological and social needs; (3) the need for individualized assessment and a prosthetic limb prescription process that is tailored to women Veterans; the current process was often perceived as biased and either dismissive of women's concerns or failing to adequately solicit them; and (4) the desire for prosthetists who listen to and understand women's needs. CONCLUSIONS: Women Veterans with LEA articulated themes reminiscent of those previously reported by male Veterans with LEA, such as the importance of prostheses and the central role of the provider-patient relationship. However, they also articulated unique needs that could translate into specific strategies to improve prosthetic care, such as integrating formal opportunities for social support and peer interaction for women Veterans with LEA, advocating for administrative changes and research efforts to expand available prosthetic component options, and ensuring that clinical interactions are gender-sensitive and free of bias.
Authors: Gayle E Reiber; Lynne V McFarland; Sharon Hubbard; Charles Maynard; David K Blough; Jeffrey M Gambel; Douglas G Smith Journal: J Rehabil Res Dev Date: 2010
Authors: Paul F Pasquina; Jack W Tsao; Diane M Collins; Brenda L Chan; Alexandra Charrow; Amol M Karmarkar; Rory A Cooper Journal: J Rehabil Res Dev Date: 2008