Experiences of lower limb prosthesis users in Kenya: a qualitative study to understand motivation to use and satisfaction with prosthetic outcomes

Abstract

Purpose

To explore the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting.

Materials and methods

This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied.

Results

Five key themes emerged: acceptance, self-determination, hope, clinician relationship and perception. These findings demonstrate the importance of hopeful thinking and a supportive community in overcoming physical and stigmatising challenges. The findings further highlight the value of the service provider relationship beyond just prescribing an assistive device.

Conclusion

These results have relevance in developing patient-centred services, assistive devices and personnel training that are responsive, motivating, and cognisant of the service user. This is of particular interest as assistive technology services are newly developed in low resource settings.

IMPLICATIONS FOR REHABILITATION

• This research provides an understanding of lower-limb prosthesis users’ satisfaction of a device and motivation for engaging with a prosthetic service within a low resource setting.

• The relationship the rehabilitation professional has with the service user plays a significant role in facilitating motivation during rehabilitation.

• Rehabilitation professionals should consider how they can foster a network of support amongst service users when planning services in remote, rural locations.

• Rehabilitation professionals should be aware of how hopeful thinking can be facilitated during rehabilitation to support motivation.

• When reviewing the success of services, or designing new service models, the service users should be consulted on what they would deem as a successful outcome.

Keywords:

• Amputation
• prosthesis
• motivation
• LMIC
• qualitative research
• Assistive Technology
• assistive devices
• service
• clinician

Acknowledgements

The researchers wish to thank all of the interviewed participants for taking the time to share their insights into life as a prosthesis user living in Mombasa.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study has been funded through the AT2030 programme – a programme that tests “what works” to improve access to Assistive Technology . This research helps supports the aims of the programme through providing recommendations on AT service delivery within a LMIC [50]. This research was funded by Foreign, Commonwealth and Development Office (FCDO, formerly Department for International Development (DFID)), grant number GB-GOV-1-300815 Award date: 28/01/2019.