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Additional Studies of the Emotional Needs of Amputees

Although a belief still exists that psychological distress is an inevitable consequence of amputation, empirical studies have failed to substantiate the grief model. Clinical governance now demands evidence-based practice, and recent studies have attempted to identify patients who are most vulnerable to postamputation emotional disorders requiring counseling intervention. Two studies are reported to attempt to replicate previous findings in a new cohort of patients and to confirm the greatest need for counseling occurring in the 6- to 24-month postoperative period. The first study established that tumor and trauma patients are more likely to experience emotional difficulties and that depression and anxiety, followed by body image problems, are the most prevalent problems, although they occur in only about half of the sample. The second study was able to show that although the acceptance rate of an invitation for counseling at about the 6-month point was low (23% of those eligible), trauma patients accounted for most of the respondents. The studies conclude that counseling services should be audited to demonstrate that they are appropriately targeted at younger trauma or tumor patients some months after surgery.