Transfemoral amputation and prosthesis provision in Tanzania: Patient and provider perspectives.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES
Mayur Urva, Claire A Donnelley, Sravya T Challa, Billy T Haonga, Saam Morshed, David W Shearer, Nooshin Razani
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Abstract

Background: The burden of disability because of traumatic limb amputation, particularly transfemoral amputation (TFA) is disproportionately carried by low- and middle-income countries. The need for improved access to prosthesis services in these settings is well-documented, but perspectives on the burden imposed by TFA and the challenges associated with subsequent prosthesis provision vary among patients, caregivers and healthcare providers.

Objectives: To examine the burden of TFA and barriers to prosthesis provision as perceived by patient, caregiver and healthcare professional, at a single tertiary referral hospital in Tanzania.

Method: Data were collected from five patients with TFA and four caregivers recruited via convenience sampling, in addition to 11 purposively sampled healthcare providers. All participants participated in in-depth interviews regarding their perceptions of amputation, prostheses and underlying barriers to improving care for persons with TFA in Tanzania. A coding schema and thematic framework were established from interviews using inductive thematic analysis.

Results: All participants noted financial and psychosocial burdens of amputation, and perceived prostheses as an opportunity for return to normality and independence. Patients worried about prosthesis longevity. Healthcare providers noted significant obstacles to prosthesis provision, including infrastructural and environmental barriers, limited access to prosthetic services, mismatched patient expectations and inadequate coordination of care.

Conclusion: This qualitative analysis identifies factors influencing prosthesis-related care for patients with TFA in Tanzania which are lacking in the literature. Persons with TFA and their caregivers experience numerous hardships exacerbated by limited financial, social and institutional support.

Contribution: This qualitative analysis informs future directions for research into improving prosthesis-related care for patients with TFA in Tanzania.

Abstract Image

坦桑尼亚经股骨截肢和假体的提供:患者和提供者的观点。
背景:创伤性肢体截肢,特别是经股截肢(TFA)造成的残疾负担不成比例地由低收入和中等收入国家承担。在这些环境中,需要改善获得假肢服务的机会,这是有充分证据的,但对TFA带来的负担和随后提供假肢相关的挑战,患者、护理人员和医疗保健提供者的观点各不相同。目的:研究坦桑尼亚一家三级转诊医院患者、护理人员和医疗保健专业人员对TFA负担和假肢提供障碍的看法。方法:从5名TFA患者和4名护理人员中收集数据,通过方便抽样,此外还有11名有目的抽样的医疗保健提供者。所有参与者都参加了深入访谈,内容涉及他们对坦桑尼亚截肢、假肢和改善对TFA患者护理的潜在障碍的看法。通过访谈,采用归纳主题分析法,建立了编码图式和主题框架。结果:所有参与者都注意到截肢的经济和社会心理负担,并将义肢视为回归正常和独立的机会。患者担心假体寿命。医疗保健提供者指出,提供义肢方面存在重大障碍,包括基础设施和环境障碍、获得义肢服务的机会有限、患者期望不匹配以及护理协调不足。结论:本定性分析确定了影响坦桑尼亚TFA患者假体相关护理的因素,这些因素在文献中缺乏。TFA患者及其照顾者经历了许多困难,而有限的经济、社会和机构支持加剧了这些困难。贡献:这一定性分析为改善坦桑尼亚TFA患者的假体相关护理的未来研究方向提供了信息。
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来源期刊
African Journal of Disability
African Journal of Disability HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
5.90%
发文量
50
审稿时长
20 weeks
期刊介绍: The African Journal of Disability, the official journal of CRS, AfriNEAD and CEDRES, introduce and discuss issues and experiences relating to and supporting the act of better understanding the interfaces between disability, poverty and practices of exclusion and marginalisation. Its articles yield new insight into established human development practices, evaluate new educational techniques and disability research, examine current cultural and social discrimination, and bring serious critical analysis to bear on problems shared across the African continent. Emphasis is on all aspects of disability particularity in the developing African context. This includes, amongst others: -disability studies as an emerging field of public health enquiry -rehabilitation, including vocational and community-based rehabilitation -community development and medical issues related to disability and poverty -disability-related stigma and discrimination -inclusive education -legal, policy, human rights and advocacy issues related to disability -the role of arts and media in relation to disability -disability as part of global Sustainable Development Goals transformation agendas -disability and postcolonial issues -globalisation and cultural change in relation to disability -environmental and climate-related issues linked to disability -disability, diversity and intersections of identity -disability and the promotion of human development.
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