Effectiveness of a Peer Visitation Program to Improve Patient Activation and Functional Outcomes and Quality of Life During Amputation Rehabilitation
Abstract
There are 85,000 and Veterans and 2 million civilians living with limb loss in the US. The emotional adjustment to an amputation is a challenging aspect of rehabilitation. It is difficult for healthcare professionals to fully educate and prepare amputee patients because they have not shared the same experience of amputation. Peer visitation allows the patient to speak directly with another amputee who has shared those similar experiences, enabling the patient to relate feelings and concerns about the loss of a limb. There is increasing national and international interest in this type of patient education. A wide variety of organizations, including hospitals and community-based facilities, are offering patient education and peer visitation programs. The ultimate anticipated outcome for individuals attending these programs is improvement in quality of life. Patient empowerment, self-efficacy, and self-management have also been found to be key intermediate outcomes. Peer support and navigation was introduced as an intervention to reduce patient barriers and achieve optimal healthcare outcomes. The Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 was enacted to provide funds to create patient navigation programs in various centers throughout the United States. The National Limb Loss Resource Center estimates there are 185,000 amputations in the United States each year. These statistics continue to increase because of the aging population and complications from diabetes mellitus and peripheral vascular disease. Losing a limb is a life-changing event that one should not go through alone. Social support has long been recognized as an important aspect to well-being and health. Various studies have demonstrated that peer support decreases the incidence of depression by addressing participant’s fears and anxieties about their limb loss. The primary concerns for the amputee and their family are lifestyle changes such as altered body image, fear of dependency, and altered mobility. Peer support works to fill the void of a limb loss by working with the amputee and discussing these lifestyle changes post-amputation. Key components of an effective navigation or peer support program can be: a population-based registry, a navigator system that matches Veterans to programs, a menu of self-management support programs designed to improve between-visit support and leverage the assistance of patient-peers and informal caregivers. The mission of the Amputee Coalition (AC) is to reach and empower people affected by limb loss. The AC assists amputees achieve their full potential through education, support, and advocacy and has established the only known Peer Visitation Program (PVP). The VA (US Department of Veterans Affairs) has partnered with the AC to establish peer support programs as part of the Amputee System of Care. Personnel from the VA obtain certification through the AC to train peer supporters. These certified trainers have trained and certified Veterans with amputations across the country to be peer supporters for fellow Veterans with amputations. While the AC PVP program is the only nationally recognized PVP for amputees, it has not been tested for effectiveness. Therefore, the purpose of this study is to demonstrate that a PVP, specifically the AC PVP, may improve functional outcomes in Service member, Veteran, and civilian lower extremity amputees during amputation rehabilitation. This 3-year study will specifically benefit military personnel and Veterans who are living with limb loss. The information learned could inform healthcare practitioners in the Armed Forces, VA, and private sector. The study timeline begins with enrollment and ends with a robust dissemination plan to a wide audience of healthcare professionals and amputees. Amputation is an unfortunate consequence of war and there are a significant number of Veterans living with limb loss. Service members and Veterans unde
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710478
Entities
People
- Jason Kahle
Organizations
- Prosthetic Design + Research (United States)
- United States Army