A comparison of children without impairment and children after amputation and limb -salvage procedures on measures of functional, social, and psychological adjustment

This study compares the functional, social, and psychological adjustment of adolescents (13-19 years of age) after amputation and limb-salvage surgery to a normal control group. Fifty-eight participants (26 with amputation, 13 with limb-salvage procedure, and 19 normal controls) were recruited.;No significant differences were found between the amputation and limb-salvage groups on the Childhood Amputee Prosthetics Project-Functional Status Inventory (CAPP-FSI) physical function score. Follow-up analyses examining only upper or lower body function found better function for the limb-salvage group than the amputee group on upper body CAPP-FSI function scores only. No significant group differences were found on measures of parent-reported pain severity or pain interference with activities or on adolescent-reported average, current, highest, or lowest pain.;No significant differences were found between the amputation, limb-salvage, or control group on the predictor variables (Harter Parent Support, Classmate Support, Perceived Physical Appearance, and Behavioral Assessment System for Children Parent Report Scale-Adolescent version Social Skills scale (BASC PRS-A) or on the adjustment outcome measures (BASC PRS-A Internalizing Scale, BASC PRS-A Externalizing Scale, Harter Global Self-Worth scale). Overall, the three groups demonstrated similarly positive adjustment on all measures.;In order to evaluate aspects of Wallander and Varni's (1992) Disability-Stress-Coping model of adjustment, MANOVA analyses were performed. No significant main effect for Group was found on any of the adjustment outcomes in this study. Significant main effects for BASC PRS-A Social Skills were found for the BASC PRS-A Internalizing Scale and Harter Global Self-Worth scale. Significant main effects for Classmate Support were found for the Harter Global Self-Worth Scale. A significant interaction was found between Group and Perceived Physical Appearance in the prediction of BASC Internalizing scores only. Results of this study indicate generally positive functional, social, and psychological adjustment after amputation and limb-salvage.;Results support the notion that Classmate Support, Social Skills, and Perceived Physical Appearance are important correlates of adjustment for all children. A buffering effect was found for high Perceived Physical Appearance on symptoms of anxiety, particularly after amputation, suggesting that this may be an important correlate of adjustment after disfigurement.