Experiences of Limb Difference : Psychological entailments and support

Malouta, Rania and Murray, Craig (2023) Experiences of Limb Difference : Psychological entailments and support. PhD thesis, Lancaster University.

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Abstract

The current thesis consists of a literature review, an empirical paper, and a critical appraisal of the process undertaken. The systematic literature review presented thematically the specific areas of limb difference and rehabilitation that have been studied through interpretative phenomenological analysis (IPA). The process followed was similar to that of thematic analysis and four themes were identified: 1) The process of learning, supporting. and alternative ways to receiving help; 2) Physical and psychological adjustment to limb difference; 3) Experiences of using prosthetics; and 4) Experiences of romantic relationships and sexuality. The adherence of the presented studies to IPA guidelines was assessed using a qualitative tool specifically designed for the quality appraisal of IPA studies and studies were given an overall score of ‘Poor’, ‘Acceptable’ or ‘Good’. The findings highlight the experiences of living with limb difference, the support available and the psychological entailments around adjustment, prosthesis use and relationships. Clinical Implications are discussed in the context of improving the rehabilitation offered by psychologists and other professionals. The appraisal of IPA adherence paves the way to completing IPA research of high standard. The empirical paper explored the experiences of receiving psychological support following limb loss. Semi-structured interviews were conducted with five participants and data was analysed using IPA. Four themes were generated by the data analysis: 1) The need for psychological intervention - denial and acceptance; 2) ‘Safe space’ - being valued, heard, and validated; 3) The importance of focus, transparency, and specialist knowledge; and 4) The most helpful techniques and approaches. Clinical implications focused on the ways psychological support is provided. Finally, the critical appraisal offered an overview of practical, methodological, ethical, and personal reflections on the research process undertaken. The importance of reflexivity and the intricate relationship between being a clinician and a researcher were considered.