Christensen J.1,2, Langberg H.2, Doherty P.3, Egerod I.4
1Copenhagen University Hospital, Rigshospitalet, Dept of Occupational- and Physiotherapy, Copenhagen, Denmark, 2University of Copenhagen, CopenRehab, Faculty of Health, Dept of Social Medicine, Copenhagen, Denmark, 3University of York, Department of Health Sciences, York, United Kingdom, 4University of Copenhagen, Rigshospitalet, Neurointensive Care Unit, Copenhagen, Denmark
Background: Acute postoperative in-hospital rehabilitation of veterans after an amputation is crucial as the likelihood of 1-year survival increases among veterans receiving rehabilitation. Furthermore, rehabilitation-related factors such as lower limb strength and balance is significantly related to ability to perform high-level mobility activities and participation in sports activities is associated with better health related quality of life. However, knowledge about the organization and factors of importance to rehabilitation is sparse.
Purpose: The study aimed to increase understanding and investigate key factors of importance for rehabilitation of veterans with lower limb amputations.
Methods: We used a qualitative explorative design triangulating interviews and participant observation.Data were generated using in-depth semi-structured interviews (n=6) exploring in-hospital and post-hospital rehabilitation after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation during weekly post-hospitalization rehabilitation and included field notes in the dataset.
Results: Two main themes emerged: Experiencing different identities and Experiencing discontinuity in rehabilitation. The first theme showed how veterans actively shifted between the identities of disabled person, wounded veteran, and athlete according to the context. The second theme illustrated the frustration of negotiating military versus civilian mindsets during rehabilitation and lack of coordination between the public healthcare system, municipal services and the military.
Conclusion(s): Veterans live with shifting identities after returning to civilian life, increasing their awareness of the transition from active service to a new life as civilian. During rehabilitation, it is important to acknowledge the disparities between the military and civilian mindsets and to integrate the different sets of values, such as structure versus autonomy.
Implications: Recommendations for the improvement of rehabilitation of amputated veterans:
· Shifting the focus from disabilities to abilities
· Integrating civilian and military goals, e.g. autonomy, structure, clear expectations, goal setting and ongoing testing
· Increasing collaboration between civilian and military rehabilitation services
Funding acknowledgements: The authors have no conflicts of interest to declare, but the first author was funded by the Danish Defence Agreement.
Topic: Disability & rehabilitation
Ethics approval: The study complied with ethical principles presented in the Helsinki Declaration. The Danish data protection agency approved the study (RH#30-1337).
All authors, affiliations and abstracts have been published as submitted.
