A prospective study of the importance of life goal characteristics and goal adjustment capacities in longer term psychosocial adjustment to lower limb amputation

Objective: To explore the life goal characteristics and goal adjustment capacities of persons with lower limb amputation on admission to rehabilitation, and to examine their efficacy as predictors of psychosocial outcomes 6 months post-discharge. Design: Prospective, descriptive. Setting: Two specialist inpatient rehabilitation facilities in Ireland. Subjects: A consecutive sample of 64 patients with lower limb amputation. Main measures: On admission to rehabilitation, life goal characteristics (goal importance, goal disturbance) were assessed using the Goal Facilitation Index and goal adjustment capacities (goal disengagement, goal re-engagement) were measured using the Goal Adjustment Scale. The Beck Depression Inventory-II and the Trinity Amputation and Prosthesis Experience Scales-Revised assessed depressive symptomatology and psychosocial adjustment to amputation at 6 months post-discharge. Results: The highest average importance ratings were assigned to goals associated with interpersonal relationships, independence, and subjective well-being. Goals related to physical limitations and disruptions in daily activities received the highest hindrance ratings. Goal importance (β = -0.33) and goal disengagement (β = -0.29) on admission significantly predicted depressive symptomatology 6 months post-discharge (p ≤ .05). Goal importance (β = 0.32), goal disturbance (β = -0.26), and goal re-engagement (β = -0.21) on admission significantly predicted general adjustment to lower limb amputation at 6 months post-discharge (p ≤ .05), while goal importance (β = -0.32) and goal disturbance (β = 0.30) significantly predicted social adjustment (p ≤ .05). Conclusions: Life goal characteristics and goal adjustment capacities on admission to rehabilitation predicted psychosocial outcomes 6 months post-discharge among individuals with lower limb amputation