Background: Cosmesis has been found to have an impact on prosthesis users' body image. Therefore the satisfaction of the cosmesis plays an essential role in a prosthesis user perception of themselves. Most cosmeses on the market are natural-looking, although more futuristic options are coming to the market. Most of the previous evidence has been conducted using quantitative methods. There is a lack of research investigating the experiences of cosmesis in transtibial prosthesis users through qualitative methods. This is expected to elucidate potentially undiscovered areas and factors surrounding patient satisfaction.  Purpose: The aim of this thesis is to explore transtibial prosthesis user's satisfaction with the appearance of their cosmesis and gain a deeper understanding of their experiences regarding cosmeses.  Methods: The method in this thesis is a qualitative phenomenology approach with an interpretivist view. The experiences of 5 male transtibial users regarding their cosmesis and satisfaction towards it were explored. This was done by having in-depth semi-structured interviews that were analyzed with thematic analysis.  Results: The results five main themes arrived: Satisfaction, Natural-looking cosmesis, Function, Difficulties with the material, and Awareness. The results of these themes showed that the participants have different experiences regarding cosmesis.  Conclusion: This thesis found a variation regarding satisfaction of the appearance among unilateral transtibial prosthesis users. Similarities in satisfaction and experience were found in the respective age groups of the participants. However, due to saturation not being fully reached, there should be further investigations. / Bakgrund: Kosmetik har visat sig påverka protesanvändarnas kroppsuppfattning. Därför spelar tillfredsställelsen av kosmetiken en viktig roll i en protesanvändares mentala hälsa och kroppsuppfattning. Huvuddelen av den kosmetik som finns på marknaden har ett mer naturligt utseende, även om mer futuristiska alternativ har blivit mer vanliga på marknaden. De flesta av de tidigare redovisade studierna har genomförts med hjälp av kvantitativa forskningsmetoder. Det saknas ännu forskning som undersöker erfarenheterna när det gäller kosmetik hos transtibialt amputerade protesanvändare utförda med kvalitativa metoder. Studien förväntas belysa potentiellt oupptäckta områden och faktorer kring patientnöjdhet. Syfte: Syftet med denna studie är att utforska transtibialt amputerade protesanvändares tillfredsställelse med utseendet på deras kosmetik och få en djupare förståelse för deras erfarenheter av kosmetik. Metoder: I denna avhandling är ett kvalitativt fenomenologiskt tillvägagångssätt med ett interpretivistiskt förhållningssätt. Erfarenheter från 5 manliga transtibialt amputerade protesanvändare med avseende på proteskosmetik och deras tillfredsställelse med användandet kosmetik undersöktes. Detta genomfördes genom att ha djupgående halvstrukturerade intervjuer som analyserades med ett tematiskt förhållningssätt. Resultat: I resultaten framkom i huvudsak 5 huvudtema: Tillfredsställelse, kosmetik med naturligt utseende, funktion, svårigheter med material och medvetenhet. Resultaten av dessa teman visade att deltagarna har stora variationer när det gäller erfarenheter och användandet av kosmetik. Slutsats: Denna studie fann en betydande variation när det gäller tillfredsställelse av utseendet bland ensidiga användare av transtibiala proteser. Likheter inom tillfredsställelse och erfarenhet kunde noteras i deltagarnas respektive åldersgrupper. På grund av att mättnad (saturation) inte uppnåddes helt finns ett forsatt behov av ytterligare studier inom området.

Thesis (MScMedSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Lower limb amputations cause multiple physical, psychological, environmental and socioeconomic barriers. Individuals who have suffered a lower limb amputation require comprehensive rehabilitation to ensure social integration and economic self-sufficiency. In addition, constant monitoring and evaluation is an essential part of human service delivery programmes. However, the amputation rehabilitation programme offered at Elangeni an outpatient rehabilitation centre for clients with physical disabilities in Paarl, Western Cape, South Africa is not monitored, and has not been evaluated since its inception in 2000. Thus, the current study evolved to describe and evaluate the rehabilitation programme for persons with lower limb amputations at Elangeni. A mixed method descriptive design was implemented. All persons who received rehabilitation, after a major lower limb amputation at Elangeni, between 2000 to 2011, were included in the study population. In addition, the physiotherapist and occupational therapist that provided amputation rehabilitation at Elangeni, at the time of the study, were interviewed. Thirty participants who met the study inclusion criteria were identified. Quantitative data was collected using a researcher designed, structured demographic questionnaire, an International Classification of Function checklist based questionnaire and a participant rehabilitation folder audit form. Two interview schedules one for clients and one for therapists were used for guidance during semi structured interviews. Quantitative data was entered onto a spread sheet and analysed by a statistician using Statistica, version 8. Qualitative data was thematically analysed according to predetermined themes. No programme vision, mission or objectives could be identified for the amputation rehabilitation programme. Poor record keeping practices and a lack of statistics were found. Rehabilitation was impairment focused with no attention given to social integration. Clients who received prosthetic rehabilitation showed improved functional ability with regard to picking up objects from the floor (p = 0.031) getting up from the floor (p = 0.00069), getting out of the house (p = 0.023), going up and down stairs with a handrail (p = 0.037) and moving around in the yard (p = 0.0069), climbing stairs without a handrail (p = 0.037), going up and down a kerb (p = 0.0082) walking or propelling a wheelchair more than 1km (0.0089) and walking in inclement weather (0.017). A lack of indoor mobility training had a statistically significant negative impact on the participants’ ability to lift and carry objects (p 0.011), standing up from sitting (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016), going up and down stairs with a handrail (p = 0.019), moving around in the yard (0.0013), going up and down stairs with-out a hand-rail (p = 0.019), getting up and down a kerb (p = 0.0022), walking or wheeling 1km or more (p = 0.0032) and using transport (p = 0.0034). Failure to address community mobility during rehabilitation had a statistically significant negative impact on all aspects of community mobility scores except doing transfers and driving. In conclusion, for the study participants, Elangeni failed to provide rehabilitation according to the social model of disability and Community Based Rehabilitation principles. It is recommended that managers, service providers, and clients re-consider the purpose of Elangeni and develop a vision and objectives for that service. In addition, management should take an active role in service monitoring and evaluation and provide guidance and mentorship to therapists. / AFRIKAANSE OPSOMMING: Onderste ledemate amputasies impak negatief op `n persoon se fisiese, sielkundige en sosiale funksionering. Individue wat ’n amputasie ondergaan het benodig omvattende rehabilitasie om sosiale integrasie en ekonomiese onafhanklikheid te verseker. Konstante monitering en evaluasie is ’n essensiële deel van rehabilitasie programme. Nietemin die amputasie rehabilitasie program wat by Elangeni aangebied word, word nie gemoniteer nie en was nog nooit geëvalueer nie. Dus het hierdie studie dit ten doel om die rehabilitasie programme vir persone met onderste ledemate amputasies by Elangeni te beskryf en te evalueer. Kwantitatiewe en kwalitatiewe navorsingsmetodes is in kombinasie gebruik in die studie. Alle persone wat rehabilitasie by Elangeni ontvang het na ’n onderste ledemaat amputasie, sowel as die terapeute wat by Elangeni werk, het die studie populasie gevorm. In totaal het 32 persone aan die studie deelgeneem. Kwantitatiewe data is met behulp van `ʼn demografiese vraelys, `ʼn ICF gebaseerde vraelys, en `ʼn leer oudit vorm ingesamel. Twee onderhoud skedules, een vir die kliënte en een vir die terapeute, is gebruik as riglyn tydens insameling van kwalitatiewe data. Kwantitatiewe data is statisties ontleed deur ʼn statistikus wat gebruik gemaak het van Statistica 8. Voorafbepaalde temas is gebruik tydens tematies ontleding van kwalitatiewe data. Geen program visie, missie of doelwitte kon geïdentifiseer word nie. Swak rekord houdings praktyke was gevind. Rehabilitasie het gefokus op die fisiese en nie op sosiale integrasie nie. Die kliënte wat prostetiese rehabilitasie ontvang het, het statisties beduidend beter gevaar ten opsigte van optel van voorwerpe van die vloer af (p = 0.031), om van die vloer af op te staan (p = 0.00069), om uit die huis uit te kom (p = 0.023), om trappe met `ʼn handreling te klim (p = 0.037), om op die erf rond te beweeg (p = 0.0069), om trappe sonder `ʼn reling te klim (p = 0.037), om by sypaadjies op en af te gaan (p = 0.0082), om meer as `ʼn kilometer te loop of met die rolstoele te ry (0.0089) en om in ongure weer te loop (0.017). `ʼn Tekort aan heropleiding van mobiliteit binne die huis het `ʼn statisties beduidende impak gehad op die vermoë om goed te dra (p 0.011), op te staan van sit af (p = 0.042), in die huis rond te beweeg (p = 0.00023), voorwerpe van die vloer af op te tel (p = 0.00068), van die vloer af op te staan (p = 0.0072), uit die huis uit te kom (p = 0.0016), trappe met `ʼn handreling te klim (p = 0.019), in die erf rond te beweeg (0.0013), trappe sonder `ʼn handreling te klim (p = 0.019), by `n sypaadjie op en af te gaan (p = 0.0022), meer as 1km te loop of met die rystoel te ry (p = 0.0032) en om vervoer te gebruik (p = 0.0034). `ʼn Gebrek aan heropleiding van gemeenskapsmobiliteit het `ʼn statisties negatiewe impak gehad op alle aspekte van gemeenskapsintegrasie behalwe die doen van oorplasings en bestuur. Rehabilitasie praktyke was nie gebaseer op die sosiale model van gestremdheid en Gemeenskap Gebaseerde Rehabilitasie beginsels nie. Dit word aanbeveel dat diens verskaffers, kliënte en bestuurders oor die fokus van rehabilitasie by Elangeni moet besin. Daar moet ʼn visie en doelwitte vir die diens ontwikkel word. Voorts moet bestuurders van distrik vlak ʼn aktiewe rol speel in die monitering en evaluasie van dienste en mentorskap aan terapeute verseker.

The aim of this thesis was to determine the effect of driving in a wheelchair and walking on crutches on the energy expenditure and cardiopulmonary system in people with lower limb amputation. For this measurement we used a device Metamax 3B made by Cortex, functioning by measuring the concentration of oxygen and carbon dioxide in the breathing air, and a sporttester made by Polar. On the basis of oxygen consumption is possible to determine an energy expenditure during the activity. Our study was attended by 11 probands (men), patient of long-term hospital in Motol Hospital. Nine probands were amputated from vascular causes, one from the traumatological causes and one from the other causes. Probands rode (or walked) for four minutes back and forth along the corridor thirty meters long. They were instructed to ride (walk) at a speed to fit their needstand to also keep the same pace for a defined period of time. Walking on crutches without prosthesis managed only three of the testing file. During the study, these values were measured: distance traveled, average speed, oxygen consumption (VO2, VO2/kg, VO2 peak), carbon dioxide output (VCO2), respiratory exchange ratio (RER), tidal volume (VT), breathing frequention (BF), minute ventilation (MV), heart rate (HR), energy expenditure and performance. In this work...

The number of patients with diabetes mellitus has been increasing recently. The so-called diabetic leg and related amputation treatment belong to the complications of the disease. Amputation or removal of the end part of a limb obviously affects not only the physical aspect of a patient, but also the psychical, social and spiritual aspects. It is therefore vital that each nurse is able to choose from suitable techniques of communication with such patients and to provide them with sufficient support in the adaptation to a new life role. Callista Roy also dealt with this issue and developed a model named after her, which can be applied to patients adapting to a newly arisen situation, which amputation of a lower limb definitely is. Three goals were set in the thesis. The first one was to find out what kind of problems patients after amputation of a lower limb see in the individual adaptation modes according to C. Roy. Then we focused on the interventions applied by nurses to the support for the adaptation in the individual adaptation modes and to what extent nurses work with stimuli in Roy's conception. The research was based on the data collection by means of a qualitative method, the techniques of semi-structured interviews, and involved observation of patients after amputation of a lower limb and of nurses working at a standard surgery department. After the saturation of the research sample set the data was analysed and processed by means of the "pencil & paper" method. The research has shown that nurses devote particular attention to the physiologic adaptation mode and to the interdependence mode in their practice. In terms of the satisfaction of the basic physiologic needs they mostly mentioned the assistance in self-service activities, in the sphere of excretion and very often also interventions contributing to pain relief. In the self-concept group identity adaptation mode nurses mostly apply suitable communication and provision of sufficient information. In terms of the role function adaptation mode we can say that nurses search for this kind of information, but no activity supporting this mode was found among the nurses. Unlike nurses, who pay the highest attention to the satisfaction of the physiologic adaptation mode and thereto related interdependence mode, patients see shortcomings in all four adaptation modes. In the physiologic adaptation mode patients mostly pointed out problems with movement manifested themselves in the deficit of self-care. In the sphere of self-concept group identity, they mentioned the feeling of helplessness and inferiority. Nearly all patients see a problem in the dependence on the nursing staff and the disability to play the roles once played. Among the most frequent stimuli affecting a patient after lower limb amputation are pains that nurses relieve by means of analgesics prescribed by physicians, patients also often mention the approach of the staff and social interaction owing to the absence of family members. The research has shown that nurses approach patients with dignity and also respect the incoming visitors. The information obtained by this research can be used as a basis for seminars focused on this issue and lead to the improvement of the nursing care about patients with amputation of a lower limb.

Estudo quantitativo, descritivo e retrospectivo de internações hospitalares de pacientes com e sem o diagnóstico de diabetes submetidos a amputação não traumática de extremidades inferiores, no período de 2001 a 2008, em Ribeirão Preto - SP - Brasil. Este estudo teve como objetivos caracterizar as internações hospitalares de pacientes com e sem o diagnóstico de diabetes mellitus submetidos a amputação não traumática de extremidades inferiores segundo sexo, idade, período da internação hospitalar, tipo de atendimento e condições da alta; relacionar as internações hospitalares com as variáveis tipo de alta e atendimento, sexo, idade e tempo de internação, e analisar a tendência das internações hospitalares em Ribeirão Preto-SP, no período de 2001-2008. Utilizaram-se dados de fonte secundária de internações hospitalares, do Sistema de Informações do Centro de Processamento de Dados Hospitalares. Os resultados mostraram que das 2296 internações hospitalares relacionadas ao procedimento de amputação não traumática de extremidades inferiores, 954 (41,6%) tinham o diagnóstico de diabetes mellitus. A maioria (58,7%) é do sexo masculino; idade média de 63,9 anos; 54,8% residiam em Ribeirão Preto-SP e 72,6% receberam assistência hospitalar pelo Sistema Único de Saúde. O tempo de internação hospitalar variou de 0 a 128 dias, média de 9,9 dias. A taxa de reinternações foi de 12,7% e de óbito 7,9%. A tendência de internações hospitalares não obedece a um padrão regular e o modelo de regressão linear ajustado para verificar a existência de tendência não mostrou significância estatística. O teste Qui-quadrado apresentou significância estatística, p-valor < 0,001, para variável sexo e o teste de Mann-Whitney mostrou significância estatística p-valor <0,001 para o tempo de internação hospitalar. Esses resultados apontam a importância de reforçar as ações de educação aos pacientes com diabetes mellitus com vistas à prevenção de amputações como desfecho da doença / Quantitative, descriptive and retrospective study of hospital admissions of patients with and without a diagnosis of diabetes mellitus undergoing non-traumatic amputation of the lower extremities, in the period from 2001 to 2008 in Ribeirão Preto - SP - Brazil. This study aimed to characterize the hospital admissions of patients with and without a diagnosis of diabetes undergoing non-traumatic amputation of lower extremities by sex, age, hospitalization time, type of care and discharge conditions; relate the hospitalizations with the variable type of discharge and attendance, sex, age and hospitalization time and analyze the tendency of hospital admissions in Ribeirão Preto-SP, in the period from 2001 to 2008. Source of data were used secondary hospitalizations, from the National Hospital Data Processing Center Information. Of 2296 hospital admissions related to non-traumatic amputation procedure of the lower extremities, 954 (41.6%) had a diagnosis of diabetes mellitus, most (58.7%) were male, mean age 63.9 years. 54.8% live in Ribeirão Preto-SP, 72.6% received hospital care by SUS, hospital stay ranging from 0 to 128 days, an average of 9.9 days. The readmission rate was 12.7% and 7.9% died. The trend of hospitalizations did not follow a regular pattern and the linear regression model adjusted to check the trend was not statistically significant.The chi-square test was statistically significant, p <0.001, for gender variable and the Mann-Whitney test revealed statistically significant p-value <0.001 for the variable hospital stay. These results show the importance of strengthening education activities to patients with diabetes in order to prevent amputations as the outcome of the disease

Este estudo avalia a qualidade de vida de sujeitos acometidos por tumores musculoesqueléticos de membros inferiores, submetidos a cirurgias de ressecção, com salvamento de membro ou amputação. A casuística foi composta por 56 sujeitos, avaliados no período de 14 meses (agosto de 2011 a setembro de 2012), que foram divididos em três grupos: 1- 12 amputados; 2- 16 em pós-operatório de salvamento do membro (colocação de endoprótese ou reconstrução biológica); 3- sujeitos saudáveis (sem diagnóstico de câncer), selecionados entre a população em geral, de forma pareada com os outros grupos, segundo sexo, idade, escolaridade e condição socioeconômica. Além do Critério de Classificação Econômica Brasil (2010), foram aplicados dois protocolos de avaliação, um de qualidade de vida (Medical Outcomes Study 36 - Item Short-Form Health Survey - SF-36) e o outro de capacidade funcional (Toronto Extremity Salvage Score - TESS), ambos adaptados culturalmente e validados no Brasil. Os dados foram estatisticamente analisados, conforme preconizado por cada protocolo. Os resultados indicaram que ambos os tipos de abordagem cirúrgica (amputação ou reconstrução) produziram prejuízos na capacidade funcional e na qualidade de vida dos sujeitos acometidos por tumores musculoesqueléticos, quando comparados à população saudável. Diferentemente do que apontaram outros trabalhos internacionais com casuística semelhante, os sujeitos submetidos a amputações apresentaram resultados melhores relacionados à sua capacidade funcional e à qualidade de vida, na maioria dos domínios do SF36 e com relevância estatística (p=0,001) no escore final do TESS, do que aqueles submetidos a técnicas de salvamento de membro. Por fim, é importante analisar a percepção dos sujeitos sobre sua funcionalidade e qualidade de vida, de modo a encontrar caminhos mais adequados no processo de reabilitação desta população. / This study appraises the quality of life of individuals with musculoskeletal tumors in lower extremities, undergoing resection surgeries with extremity salvage or amputation. The casuistry was composed by 56 subjects assessed in the course of 14 months (from August, 2001 to September, 2012), who were divided into 3 groups: 1- 12 amputated; 2- 16 in postsurgical extremity salvage (endoprosthesis implant or biological reconstruction); 3- healthy subjects (without cancer diagnosis), selected from the whole population, paired off with other groups, according to sex, age, schooling and socioeconomic status. Besides the Critério de Classificação Econômica Brasil (2010), two assessment protocols were applied, one about quality of life (Medical Outcomes Study 36 - Item Short-Form Health Survey - SF-36), and the other one about functional capacity (Toronto Extremity Salvage Score - TESS), both culturally adapted and validated in Brazil. The data were statistically analyzed according to what each protocol proclaims. The results revealed that both surgical approach types (amputation or reconstruction) caused harm to the functional capacity and to the quality of life of the subjects suffering from musculoskeletal tumors, when compared to the healthy population. Unlike what other international papers with similar casuistry have shown, the subjects undergoing amputation presented better results related to their functional capacity and quality of life, in the majority of the domains of SF36, with statistical relevance (p=0.001), than those submitted to the techniques of extremity salvage. Finally, it is important to analyze the subjects\' perception on their functionality and quality of life in order to discover the most suitable ways in the process of rehabilitating this population.

O objetivo deste estudo foi traduzir e adaptar culturalmente o Functional Measure for Amputees Questionnaire (FMA) para a população brasileira e analisar sua validade e eficácia quando aplicado em pacientes amputados de membro inferior. Métodos: O procedimento seguiu as etapas: tradução para o português, retrotradução, análise das versões por um comitê multidisciplinar e pré-teste. O questionário traduzido foi aplicado na amostra de 44 pacientes, 27 no nível transtibial e 17 transfemoral, idade média de 47,5 ±17,2 anos; em 20 pacientes a causa da amputação foi trauma, 17 por insuficiência vascular, quatro por infecção e três por tumor. O tempo médio de reabilitação foi de 6,2 meses. Foram realizadas as análises de confiabilidade teste-reteste e consistência interna. Resultados: O resultado da adaptação transcultural foi satisfatório; algumas modificações foram necessárias, porém sem nenhuma mudança na estrutura ou no conteúdo do questionário original; no estudo da confiabilidade verificamos que em média, os coeficientes Kappa foram superiores a 0,80 e 25% deles foi igual a um indicando haver excelente concordância inter e intra-entrevistadores. Na análise da consistência interna, o valor do coeficiente para a questão referente ao Índice da Capacidade Locomotora foi igual a 0,79 demonstrando haver consistência no bloco de questões relacionadas à mobilidade. Conclusão: Os resultados sugerem que a versão brasileira do FMA pode ser um instrumento confiável para medir o resultado funcional de pacientes brasileiros com amputação de membro inferior após a reabilitação. / The aim of the study was to translate a cross-cultural version of the Functional Measure for Amputees Questionnaire (FMA) into Brazilian-Portuguese and evaluate its reliability and validity for assessing lower limb amputees patients. Methods: The FMA were translated, back-translated, evaluated by a multidisciplinary committee and pre-tested. The translated e adapted version was submitted to field test on a study group composed of 44 lower limb amputees patients; their average age was 47,5±17,2. The amputation level was transtibial in 27 patients and 17 in transfemoral patients. The cause of amputation related to trauma in 20 individuals, 17 with vascular insufficiency, four infection and three with malignant tumor. The average of physical therapy treatment was 6,2 months. Test-retest reliability, internal consistency was investigated. Results: the cultural adaptation of the FMA was successfully accomplished. In the field test the inter- and intra-observer showed high reliability; the mean of kappa values was superior to 0,80 and in 25% of the questionnaire was one suggesting excellent agreement beyond chance. The internal consistency for the question about Locomotor Capabilities Index was 0,79 showing a consistency in relation to mobility. Conclusion: the Brazilian-Portuguese version of the FMA questionnaire appears to be culturally appropriate and the adapted instrument demonstrated to be a reliable instrument to measure the functional outcome of Brazilian lower limb amputees patients after rehabilitation.

Amputation av nedre extremitet drabbar cirka 2600 individer i Sverige årligen. Amputation är en stor operation som innebär en rad förändringar som exempelvis nya fysiska hinder och förändrade känslor kring sig själv och sin omgivning. Syftet med studien är att belysa individers upplevelser av livet efter en amputation av nedre extremitet. Studien är en litteraturöversikt gjord på kvalitativa artiklar där tio artiklar valdes ut och analyserades med hjälp av Fribergs (2006) analysmetod. Detta resulterade i tre huvudteman Att förlora ett ben som beskriver de känslor och problem som individerna upplever i samband med amputation. Förändrad självbild handlar om hur individen ser på sig själv och hur de uppfattar att andra ser på dem. Det sista temat, Att återfå kontroll, beskriver hur individen återfår sin självständighet och nytt hopp som gått förlorad efter amputationen. Författarna har i diskussionen fokuserat på att diskutera kring vad sjuksköterskan bör tänka på i mötet med dessa individer och vad sjuksköterskan kan göra för att hjälpa dem att återfå sin självständighet och hopp om framtiden. / Program: Sjuksköterskeutbildning

Amputation innebär en kroppslig förändring som inte enbart medför en funktionsnedsättning utan även påverkar den subjektiva upplevelsen av kroppen. De personer som genomgår en benamputation utgör en relativt liten patientgrupp sett ur ett samhällsperspektiv, trots detta är den påföljande rehabiliteringen både tidskrävande och kostsam. I sjuksköterskans arbete ingår att tillgodose patienters unika behov samt att i rehabiliteringsarbetet, understödja patienters egna resurser. Det är således viktigt för sjuksköterskan att nå ökad förståelse för de upplevelser som är förenade med en amputation samt att ha kunskap om de faktorer som kan bidra till en hälsosam rehabilitering. Syftet med denna studie är att utifrån ett patientperspektiv belysa upplevelser av benamputation. Studien bygger på analys av vetenskapligt granskade intervjustudier. Materialet är analyserat utifrån Evans (1997) kvalitativa innehålls- analys. De tre huvudteman som har framkommit i denna studie är: Initiala reaktioner på den levda kroppens förändring, Betydelsen av andras närvaro i efterförloppet av amputationen samt Att gradvis acceptera sin nya livssituation. Dessa huvudteman påvisar att de upplevelser som följer en amputation är bundna till patienters förväntningar, förberedelse, förkunskap samt var i rehabiliteringsprocessen patienten befinner sig. I resultatdiskussionen diskuteras sedan de faktorer som kan bidra till en hälsosam rehabilitering samt hur de benamputerade upplever vikten av dessa faktorer. Vidare diskuteras hur ökad kunskap och förståelse för dessa patienters upplevelser kan användas i det praktiska vårdarbetet och förhoppningsvis förkorta rehabiliteringstiden för denna patientgrupp. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

I Sverige amputeras cirka 2500 personer varje år, 80 procent av dessa beror på cirkulationsrubbningar, andra orsaker kan vara trauma eller olycka. Vi lever genom våra kroppar och när kroppen förändras kommer även livsvärlden att förändras. När en person genomgår en plötslig amputation påverkas personens välbefinnande och det blir också en omtumlande upplevelse att tvingas in i en ny livssituation, då arbetsliv, sociala livet och personliga livet påverkas av skadan. Då sjuksköterskans uppgift är att främja patientens hälsa och minska dennes lidande, är det viktigt att han/hon vet hur det är att ha drabbats av en plötslig amputation och hur patientens livsvärld har förändrats. Syftet med denna studie är att beskriva hur patienter upplever att livsvärlden förändrats efter en plötslig amputation. En kvalitativ litteraturstudie användes som metod för att få en ökad förståelse för det valda fenomenet. Resultatet presenteras i teman och subteman, dessa visar på att en person som drabbats av plötslig amputation genomgår en fysiskt och psykisk förändring, personen måste lära sig att anpassa sig till detta. Personerna som genomgått en amputation använde olika strategier för att hantera det som inträffat, exempelvis; träffa och samtala med andra som genomgått amputation eller söka stöd hos anhöriga. Det som var viktigast för alla informanterna var att uppfattas som normala av omgivningen och de ville inte bli stämplade som ett handikapp. En viktig del i detta var att ha en välanpassad protes. I diskussionen ges praktiska implikationer samt förslag på nya forskningsfrågor. / Program: Sjuksköterskeutbildning