Quality of life and associated factors among unilateral lower limb amputees at Mulago National Referral Hospital, Uganda

Abstract

Introduction: Lower Limb Amputations (LLAs) often prevent individuals from performing activities of daily living and/or participating in physical and social activities and therefore affecting the quality of life (QoL) because of the limitations in body structure and function (Akarsu et al., 2013, Sinha et al., 2011, Tseng et al., 2007). Despite the growing number of lower limb amputees in Uganda, QoL remains a relatively poorly studied concept in this population. In addition, there is paucity of information on the multitude of factors that are associated with the QoL among LLAs in the Ugandan population. Objective: To describe the quality of life and its associated factors among LLAs at Mulago National Referral Hospital, Uganda (MNRH). Methods: A cross-sectional study with both descriptive and analytical approaches was conducted. Data on QoL was obtained using a validated WHO QoL semi-structured questionnaire among 132 lower limb amputees at Mulago National Referral Hospital, Uganda. Poisson Regression was used to determine the important amputation or non-amputation related factors that were associated with QoL using STATA version 14.0. Approval was sought from the IRB, Mulago Hospital Research and Ethics Committee and the Department of Orthopedic surgery. Results: In this study, a total of 132 participants with a median age of 38, majorly males (81.8%) and most of them married (54.5%) and had some form of informal employment (54.5%). 87.1% of the participants had prosthesis, majority had left lower limb amputation (61.4%), mostly trans-tibial amputation levels (72%), and 62.8 % had no stump problems. We found a median score of 62 total points for QoL, ranging from 48 to 69. Overall, the participants rated their QoL as “good”, and most of them had neutral or indecisive responses. Amputation level, marital status, having prosthesis, employment status and having stump problems were significantly associated with QoL. Conclusion: It was found that the overall Quality of life among Lower Limb Amputees at MNRH is fairly satisfactory. I found that amputation level, marital status, having a prosthesis, stump and employment status had a significant impact on the quality of life of lower limb amputees at MNRH. I recommend an assessment of quality of life before and after lower limb amputation to further under the effect and magnitude of factors such as employment, income, and marital status that are likely to change drastically as a result of amputation.