Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 4, 2010
   Pages 373 — 386

Abstract — Quality of life for veterans and servicemembers with major traumatic limb loss from Vietnam and OIF/OEF conflicts

Richard A. Epstein, PhD;1 Allen W. Heinemann, PhD;2 Lynne V. McFarland, PhD3*

1Department of Psychiatry, Vanderbilt University, Nashville, TN; 2Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; and Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; 3Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; and University of Washington, Seattle, WA

Abstract — The goals of rehabilitation after major limb loss include not only functional restoration but also a return to a high quality of life (QOL). Few studies have identified which factors are associated with QOL in veterans and servicemembers with combat-associated major limb loss. We enrolled Vietnam and Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans and servicemembers in a national survey on prosthetic device use. In the Vietnam group, multivariate analysis found multiple limb loss (adjusted odds ratio [aOR] = 3.1, 95% confidence interval [CI] = 1.57-6.02) and satisfaction with current prostheses (aOR = 1.2, 95% CI = 1.05-1.38) are associated with better overall QOL, while a higher amputation impact rank (aOR = 0.66, 95% CI = 0.59-0.74) and depression (aOR = 0.21, 95% CI = 0.08-0.54) are associated with worse overall QOL. In the OIF/OEF group, three factors are significantly associated with worse overall QOL: combat-associated head injury (aOR = 0.78, 95% CI = 0.61-0.99), combat-associated injury to the nonamputated limb (aOR = 0.71, 95% CI = 0.57-0.88), and assistance needed in daily living (aOR = 0.12, 95% CI = 0.02-0.72). Improving satisfaction with prosthetic devices, improving mental health care, and treating other combat-associated injuries may significantly improve the overall QOL for these veterans and servicemembers.

Key words: amputation, combat injuries, limb loss, mental health, OIF/OEF, quality of life, prostheses, servicemembers, veterans, Vietnam.


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Last Reviewed or Updated  Friday, June 25, 2010 10:05 AM

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