Diversity in adjustment to a leg amputation: Case illustrations of common themes

Purpose: To provide in-depth case descriptions that illustrate the common themes in the research literature on psychological adjustment to a lower-extremity amputation as well as capture the uniqueness of each individual's response to this prevalent acquired disability. Method: Four cases were chosen based on the diversity of adjustment issues they represented. These case presentations were reconstructed from evaluations completed by the authors, all psychologists, as part of routine care on an inpatient rehabilitation service. Identifying information was changed to protect confidentiality. Conclusions: Taken together, these four cases serve to underscore the importance attending to common issues such as post-amputation depression and anxiety, body image, feelings of vulnerability, social support changes, grief, pre-amputation psychological issues and phantom limb pain and sensations. Psychological assessment and referrals for treatment should be included as part of the routine care provided to individuals with amputations, irrespective of the length of time that has passed since the amputation.