Archives of physical medicine and rehabilitation · 2015
Suicidal ideation among individuals with dysvascular lower extremity amputation.
СтатьяМногоцентровое исследованиеПоддержка правительства СШАНазвание и аннотация: Перевод в очереди
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Turner Aaron P, Meites Tiffany M, Williams Rhonda M, Henderson Alison W, Norvell Daniel C, Hakimi Kevin N, Czerniecki Joseph M
Аннотация
OBJECTIVE: To examine the estimated prevalence and correlates of suicidal ideation (SI) among individuals 1 year after a first lower extremity amputation (LEA).
DESIGN: Cohort survey.
SETTING: Four medical centers.
PARTICIPANTS: A referred sample of patients (N=239), primarily men, undergoing their first LEA because of complications of diabetes mellitus or peripheral arterial disease, were screened for participation between 2005 and 2008. Of these patients, 136 (57%) met study criteria and 87 (64%) enrolled; 70 (80.5%) of the enrolled patients had complete data regarding SI at 12-month follow-up.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: SI, demographic/health information, depressive symptoms, mobility, independence in activities of daily living (ADL), satisfaction with mobility and ADL, medical comorbidities, social support, self-efficacy.
RESULTS: At 12 months postamputation, 11 subjects (15.71%) reported SI; of these, 3 (27.3%) screened negative for depression. Lower mobility, lower satisfaction with mobility, greater impairment in ADL, lower satisfaction with ADL, lower self-efficacy, and depressive symptoms were all correlated with the presence of SI at a univariate level; of these, only depressive symptoms remained significantly associated with SI in a multivariable model.
CONCLUSIONS: SI was common among those with recent LEA. Several aspects of an amputee's clinical presentation, such as physical functioning, satisfaction with functioning, and self-efficacy, were associated with SI, although depression severity was the best risk marker. A subset of the sample endorsed SI in the absence of a positive depression screen. Brief screening for depression that includes assessment of SI is recommended.
DESIGN: Cohort survey.
SETTING: Four medical centers.
PARTICIPANTS: A referred sample of patients (N=239), primarily men, undergoing their first LEA because of complications of diabetes mellitus or peripheral arterial disease, were screened for participation between 2005 and 2008. Of these patients, 136 (57%) met study criteria and 87 (64%) enrolled; 70 (80.5%) of the enrolled patients had complete data regarding SI at 12-month follow-up.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: SI, demographic/health information, depressive symptoms, mobility, independence in activities of daily living (ADL), satisfaction with mobility and ADL, medical comorbidities, social support, self-efficacy.
RESULTS: At 12 months postamputation, 11 subjects (15.71%) reported SI; of these, 3 (27.3%) screened negative for depression. Lower mobility, lower satisfaction with mobility, greater impairment in ADL, lower satisfaction with ADL, lower self-efficacy, and depressive symptoms were all correlated with the presence of SI at a univariate level; of these, only depressive symptoms remained significantly associated with SI in a multivariable model.
CONCLUSIONS: SI was common among those with recent LEA. Several aspects of an amputee's clinical presentation, such as physical functioning, satisfaction with functioning, and self-efficacy, were associated with SI, although depression severity was the best risk marker. A subset of the sample endorsed SI in the absence of a positive depression screen. Brief screening for depression that includes assessment of SI is recommended.
Предметные рубрики MeSH
Activities of Daily LivingAgedAged, 80 and overAmputation, SurgicalAmputeesComorbidityCross-Sectional StudiesDepressionDiabetes ComplicationsFemaleHealth BehaviorHealth StatusHumansLower ExtremityMaleMiddle AgedMobility LimitationPeripheral Arterial DiseasePrevalenceProspective StudiesSelf EfficacySocial SupportSuicidal Ideation