Gender differences in physical and psychological outcomes after lower limb amputation in Iran: A comparative and mediation analysis study.

BACKGROUND AND

OBJECTIVE

This study investigates gender differences in mobility, quality of life (QoL), and self-esteem among individuals with unilateral lower limb amputation in Iran, with a focus on mediating roles of education, self-esteem, and time since amputation.

STUDY

DESIGN

In this cross-sectional study, 100 participants (52 women, 48 men) completed validated measures assessing locomotor function locomotion capability index, QoL (12-item short form survey), and self-esteem (Rosenberg Self-Esteem Scale).

RESULT: The sample consisted of 100 individuals (52 women, 48 men) with 44 ± 16 mean age for women and 45 ± 15 years for men. Mean years of education was 9.36 years an average duration of 13.32 years since amputation. Regarding the level of amputation, most participants had below-knee amputations (61%), followed by above-knee (21%), knee (11%), ankle (5%), and hip (2%) amputations. The primary causes of amputation were trauma (57%). Although no significant gender differences were found in mobility or overall QoL, women reported significantly lower self-esteem than men. Higher education levels were linked to enhanced self-esteem and better QoL. Mediation analyses revealed that gender influenced QoL indirectly through self-esteem, education, and time since amputation. Specifically, self-esteem was a key mediator linking gender to mental health outcomes, with women's lower self-esteem associated with reduced QoL.

CONCLUSION

These findings suggest that cultural and societal factors in Iran may disparately affect women's psychological adjustment to amputation. The study highlights the importance of gender-sensitive rehabilitation strategies that address self-esteem and other aspects of psychosocial well-being for women with amputation in Iran.