Living with an amputation: what it means for patients and their helpers.

The social and emotional problems declared by 134 single-leg amputees are compared with those of 109 people who were their main helpers. The Day Amputee Activity Score, the Goldberg GHQ, Townsend's Social Isolation scale and Forder's concept of Felt Need were used in the study. The majority of patients were elderly males. Most of the carers were women. Peripheral vascular disease was the most frequent reason for the amputation and its persistence postoperatively was predictive of poor rehabilitation outcome. The respondents reported unmet need for information about financial help, employment and social activity. Both groups shared a high level of social isolation, which was associated with risk of psychiatric illness and appeared to inhibit the expression of need. Helpers complained more forcefully than patients about service provision and discussed their emotional reactions more readily. The amputees tended to use denial in confronting the implications of limb ablation. Many respondents had no sources of help with personal or practical problems. Their knowledge of available services was poor. In particular, the role of social workers was not well understood. Neither the social work profession nor the Artificial Limb Centre was used to any appreciable extent as a source of help with psychosocial adjustment to loss of a limb.