Self-Management Program for Persons With Limb Loss
Condition: Amputation; Depression; Pain; Anxiety
MeSH terms: Depression
Study type: Interventional

Summary: 
      The specific aims of this study are:

        1. To develop and pilot a self-management (SM) intervention for persons with limb loss in a
           group setting using a participatory action research (PAR) strategy.

        2. To evaluate the feasiablity and effectiveness of a SM intervention within the context of
           the existng network of limb loss peer support groups

           Hypothesis #2a: The SM intervention groups will be more effective than standard support
           group activities in reducing pain, depression and anxiety, and increasing positive mood
           and improving function and overall quality of life.

           Hypothesis #2b: Improvements in pain, depression, anxiety, function and quality of life
           will correlate strongly with improvements in self-efficacy, catastrophizing, and
           satisfaction with the prosthesis and prosthetic services.

           Hypothesis #2c: Gains in outcome will be maintained for one year.

           Hypothesis #2d: Characteristics of study participants and their environment (i.e.
           sociodemographics, co-morbidities, economic and educational resources, hope, and social
           support) will correlate with outcome and mediate the effect of the intervention.

        3. To determine the costs of the intervention and examine the relationship between costs
           and effectiveness.

      Hypothesis #3a: When compared to the control support group, the SM intervention will be
      cost-effective in terms of gains in quality adjusted years of life.
    

Detailed description: 
      Approximately 1.2 million Americans are living with limb loss. Pain, psychological distress,
      reduced function and disability are common conditions following limb loss and are related to
      reduced quality of life. Our own work has identified depression, anxiety, and pain as
      significant problems for community dwelling persons with limb loss. Traditionally,
      interventions for disabling impairments and related secondary conditions focus on standard
      medical treatments such as medication, surgery or rehabilitative therapies. Self-management
      (SM) interventions, on the other hand, have been found to be effective in reducing secondary
      conditions and disability associated with some chronic conditions using individual and
      group-based delivery methods. To date, no SM intervention has been developed for, and
      evaluated in, persons with limb loss. The goal of the project is to develop and test the
      efficacy of a community-based self-management intervention for reducing pain, depression, and
      anxiety and improving positive mood, self-efficacy and function in persons with limb loss.
      The intervention will build on the already exisitng national network of community-based peer
      support groups developed by the Amputee Coalition of America (ACA). Establishing the efficacy
      of commmunity-based SM interventions for persons with limb loss has the potential to improve
      the health and quality of life for this population
    

Intervention name(s): self-management
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Keywords: amputation; depression; pain; anxiety; self-management; secondary conditions