Factors associated with vocational reintegration among the Thai lower limb amputees

Abstract

Background: Vocational reintegration is an important goal in the rehabilitation process. The amputees had to take time to adjust themselves to their new condition after lower limb amputation and that might have an impact on their vocation. As yet, there has been no information regarding vocational reintegration among the lower limb amputees in Thailand. Objectives: To study the rate of vocational reintegration, factors associated with vocational reintegration among the lower limb amputees. Material and Method: The postal survey with the questionnaires to 1,300 amputees who received the lower limb prostheses between 2001 and 2005 was conducted. The participants were divided into two groups namely the employed and unemployed groups. The Chi-Square and the Independent Sample T Test were used to compare the difference between the two groups. The multiple variables analysis by stepwise logistic regression was used to determine the associated factors. Results: Three hundred and nine questionnaires were completed among 321 returned questionnaires (response rate 24.7%). Two hundred and forty seven males and 62 females with age ranging from 18-82 years old participated. The rate of vocational reintegration was 66.7%. Demographically, the employed group had less diabetes mellitus (p = 0.001), higher educational level (p = 0.004), were younger at the time of amputation (p < 0.001) and etiologies of amputation were blast injury from mines and congenital problems (p = 0.005). Prosthetic use and problems: the employed group used no gait aids (p < 0.001), had satisfactory to good wearing comfort (p = 0.005), wore prostheses longer hours per day (p < 0.001). The factors associated with vocational reintegration were etiologies of amputation from the blast injury from mines and congenital problems (OR 3.3), educational level from secondary school (OR 2.3), at least satisfactory to good wearing comfort (OR 1.16), and younger at the time of amputation (OR 0.97) respectively. Conclusion: This information can assist the rehabilitation personnel to encourage the vocational reintegration among the Thai lower limb amputees.