"I was angry that I fell" all the way to "if I fall, I fall": a qualitative study of the spectrum of behavioral fall risk factors for veterans with dysvascular lower-limb amputation

从“我摔倒了,我很生气”到“如果我摔倒了,那就摔倒吧”:一项针对患有血管功能障碍性下肢截肢的退伍军人的行为跌倒风险因素谱的定性研究

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Abstract

PURPOSE: To explore behavioral risk factors contributing to fall and near-fall scenarios for Veterans with dysvascular lower-limb amputation. MATERIALS AND METHODS: Participants were a convenience sample of Veterans with unilateral dysvascular lower-limb amputation, receiving care at a single Veterans Administration Regional Amputation Center, who participated in an interview (12/2021-04/2023). We used phenomenological research and directed content analysis to explore participant perspectives on fall scenarios. Two frameworks informed a priori codes (The Health Action Process Approach, and the Falls-Type Classification Framework); however, analysis was also inductive, with additional codes emerging. Following an independent and iterative coding process, codes were categorized, and patterns identified to create final themes. RESULTS: Twenty-one veterans completed interviews. Five themes were identified that were salient across a behavioral fall risk factor spectrum from low to high: self-efficacy, trust in the prosthesis, dual-task awareness, participation, and emotional regulation, and one theme pertaining to context surrounding the index fall. CONCLUSION: Different levels of behavioral fall risk factors exist for Veterans with dysvascular lower-limb amputation. Understanding individuals' perceptions of these behavioral risk factors is important as a first step in developing comprehensive fall-risk management rehabilitation interventions for Veterans with amputation.

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