Understanding transitions in care for people with major lower limb amputations from inpatient rehabilitation to home: a descriptive qualitative study

Abstract

Purpose

To understand how people with major limb amputation experience the transition in care from inpatient rehabilitation to the community.

Method

A qualitative study was conducted using semi-structured interviews. Individuals were eligible if they had undergone a major lower limb amputation and had been discharged from inpatient rehabilitation to the community within one to twelve months. Interviews explored participants’ experiences and factors associated with the transition in care. The interviews were audio-recorded, transcribed, and thematically analyzed.

Results

Nine individuals with major lower limb amputation participated. Five themes were identified to describe the transition in care experience: (a) Preparedness: differing experiences during inpatient rehabilitation; (b) Challenges with everyday tasks: “everything has to be thought out”; (c) Importance of coping strategies; “gradually you accept it more and more” (d) Importance of support and feeling connected; “if I needed anything, they’re right there” and (e) Not everyone has access to the same resources: “left to your own devices”.

Conclusions

The identified themes concurrently influenced the transition from inpatient rehabilitation to the community. Common challenges during the initial transition were identified. Areas of improvement within inpatient rehabilitation included individualized care, discussions surrounding expectations, and better access to ongoing community support.

Implication for rehabilitation

• Transition in care are difficult and vulnerable times for people with major lower limb amputation, especially when transitioning home following inpatient rehabilitation.

• Rehabilitation should prepare individuals for completing meaningful tasks in the home and community.

• Access to ongoing support in the community in the form of practical and emotional support can ease the challenges of transitioning home.

Keywords:

• Amputation
• transitions in care
• lower limb
• discharge
• rehabilitation
• qualitative research

Acknowledgements

The authors acknowledge Janet Campbell for her assistance with participant recruitment. This research was completed in partial fulfillment of the requirements for a Master of Science in Physical Therapy at the University of Toronto, with guidance from advisors Kelly O’Brien, Stephanie Nixon, Nancy Salbach, and Esther Waugh. Dr. Guilcher is supported by a Canadian Institutes of Health Research Embedded Clinician Scientist Salary Award (Grant #147869) on Transitions in Care working with Ontario Health (Quality).

Disclosure statement

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

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research was supported by the Canadian Institutes of Health Research Embedded Clinician Salary Award (Grant #147869) working with Ontario Health (Quality). The opinions, results and conclusions reported herein are those of the authors and are independent from the funding sources.