Malik, Shaneela and Murray, Craig and Simpson, Jane (2018) Coping and adjustment in adults with limb loss. PhD thesis, Lancaster University.
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Abstract
This thesis is comprised of a literature review, a research paper and a critical appraisal of theresearch process. A meta-synthesis methodology was used for the literature review in order to identify and synthesise 29 studies exploring the experiences of individuals living with limb loss. Four themes emerged which offered an understanding of how individuals with limb loss experience and cope with appearance related stigma. These were: ‘The need for social connection versus independence’, ‘Identity formation: renegotiating self’, ‘Concealing and/or avoiding’, and ‘Internal resilience: new ways of thinking and relating’. The themes capture the way individuals navigate stigma experiences, make sense of difference and establish control. The review offers implications for future research and offers recommendations for the provision of psychological input on a systemic, individual and institutional level. The research paper investigated prosthetist communication style in predicting psychosocial adjustment across three outcome measures. A cross sectional design was utilised in order investigate service user satisfaction with their prosthetists’ communication style, in order to establish whether this demonstrated significant predictive value in prosthesis related adjustment outcomes above that consistently demonstrated by other predictors. Results were interpreted using hierarchical regression analysis. One significant finding revealed that service user satisfaction with prosthetist communication style in consultations demonstrated significant predictive value above other predictors in explaining prosthesis satisfaction, particularly functional and aesthetic components to the prosthesis. Furthermore, service user satisfaction with consultation emerged as a significant independent predictor. The findings have implications for theory, clinical practice and future research in this field. Specifically, theoretical considerations of adjustment, introduction of staff training in communication and suggestions relating to more specific policy guidance in relation to prosthetic consultation are offered.