FACTORS ASSOCIATED WITH QUALITY OF LIFE, DEPRESSION AND ANXIETY AMONG TRAUMATIC AMPUTEES: A SYSTEMATIC REVIEW

Abstract

Background: Amputation is known to have a negative impact on QoL, depression and anxiety. In comparison to amputees of other causes, the impact of amputation last longer among traumatic amputees as they generally have a longer life expectancy. Understanding the risk factors associated with QoL, depression and anxiety will be crucial in lowering these negative impacts of amputation. However, current systematic reviews have not been able to establish the most common risk factors among traumatic amputees yet. Objectives: To identify the most common risk factors affecting the QoL, depression and anxiety among traumatic amputees. Methods: A systematic search for studies from January 2011 to December 2020 was conducted on PubMed, Embase, Cochrane, PsycINFO, CINAHL, Scopus and ProQuest Dissertations & Theses based on the search concepts: ‘traumatic amputation’, ‘QoL’, ‘depression’ and ‘anxiety’. The JBI critical appraisal tools were used to critically appraised the quality of included studies. A systematic narrative synthesis was performed. Results: A total of 17 studies were included in the narrative synthesis. The overall sample comprised of 2370 traumatic amputees from seven countries. The common measurement tools used were SF-36 and SF-12, BDI and BAI for QoL, depression and anxiety respectively. Several possible factors such as functional status, type and level of amputation, pain, gender and age were identified in association to QoL. Level of amputation and pain were also found to be in relation to levels of depression. However, insufficient evidence was found for risk factors of anxiety. Conclusion & Implications: The findings of this study can provide better detection and assessment of those most at risk. This enables appropriate preventive interventions to be instituted earlier. It also highlights the need for further research on the mental health impacts of traumatic amputation.