Perceptions of finger-amputated hand appearance and its effects on social life from the perspectives of affected and unaffected individuals

Yıl 2023, Cilt: 6 Sayı: 4, 751 - 755, 30.07.2023

Zeynel Mert Asfuroğlu , Metin Manouchehr Eskandari

https://doi.org/10.32322/jhsm.1297237

Öz

Aims: Traumatic finger amputation leads to dysfunction and disfigurement of the hand. Hand disfigurements can affect the social lives of affected individuals. The purpose of this study was to investigate affected and unaffected individuals' perceptions of finger-amputated hand appearance and its effects on social life.
Methods: A group of 26 finger-amputated individuals completed a questionnaire assessing the impact of their hand appearance on their social lives and rated their hand appearance using a visual analogue scale (VAS). Hand photographs of members of this group were shown to 50 unaffected individuals, who were asked to rate their appearance using the VAS and complete a questionnaire assessing their reactions to similar hands encountered during daily life.
Results: In the patient group, the mean VAS and questionnaire scores were 5.1±2 (range: 1–10), and 60.3±17 (range: 31–94), respectively. In the assessor group, the mean VAS score for all 26 hand photographs was 7.1±2 (range: 3–9) and the mean questionnaire score was 83.6±11 (range: 56–100). While the patients' and assessors' VAS scores were significantly correlated for each hand photograph (r=0.511, p=0.008), in total, 21 of the 26 VAS scores were lower for the patient than assessor group. The VAS and questionnaire scores in the patient group improved significantly with time since amputation (p =.00 and p=0.011, respectively).
Conclusion: The self-evaluation results of the affected group were worse than those of the unaffected group in terms of perceptions of appearance and the resultant effects on their social lives. We conclude that individuals without finger-amputated hands perceived hand disfigurements less negatively than affected patients. This knowledge may aid the psychosocial support of patients with hand anomalies.

Anahtar Kelimeler

Finger-amputated, hand appearance, perception, psychosocial impact

Kaynakça

• Crowe CS, Massenburg BB, Morrison SD, et al. Global trends of hand and wrist trauma:a systematic analysis of fracture and digit amputation using the global burden of disease. 2017 study. Inj Prev. 2020;26:115–124.
• Samantaray SA, Oommen J, Thamunni CV, et al. Fingertip injury epidemiology:an Indian perspective. J Plast Surg Hand Surg. 2022;56(4):224-228.
• Tejedor Navarro A, Vendrell Jordà M, Puente Alonso C. Digital replantation/revascularization: predictive factors to microsurgery success-a single-center study. Eur J Trauma Emerg Surg. 2021;47(1):225-232.
• Kükrek H, Moog P, Nedeoglo E, et al. The declining number of finger replantations in Germany. Ann Plast Surg. 2022;88(1):44-48.
• Wood SM, Kim YJ, Seyferth AV, et al. Quality metrics in hand surgery: a systematic review. J Hand Surg Am. 2021;46(11):972-979.
• Johnson SP, Sebastin SJ, Rehim SA, Chung KC. The importance of hand appearance as a patient-reported outcome in hand surgery. Plast Reconstr Surg Glob Open. 2015;3(11):e552.
• Rehim SA, Kowalski E, Chung KC. Enhancing aesthetic outcomes of soft-tissue coverage of the hand. Plast Reconstr Surg. 2015;135(2):413-28.
• Thompson A, Kent G. Adjusting to disfigurement: processes involved in dealing with being visibly different. Clin Psychol Rev. 2001;21(5):663-682.
• Duncan JAL, Bond JS, Mason T, et al. Visual analogue scale scoring and ranking:a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg. 2006;118(4):909-918.
• Goldfarb CA, Patterson JM, Maender A, Manske PR. Thumb size and appearance following reconstruction of radial polydactyly. J Hand Surg Am. 2008;33(8):1348-1453.
• Goldfarb CA, Steffen JA, Stutz CM. Complex syndactyly:aesthetic and objective outcomes. J Hand Surg Am. 2012;37(10):2068-2073.
• Kovacs L, Grob M, Zimmerann A, et al. Quality of life after severe hand injury. J Plast Reconstr Aesthet Surg. 2011;64(11):1495-1502.
• Singer G, Thein S, Kraus T, Petnehazy T, Eberl R, Schmidt B. Ulnar polydactyly - an analysis of appearance and postoperative outcome. J Pediatr Surg. 2014;49(3):474-476.
• Kristjansdottir F, Dahlin LB., Rosberg HE, Carlsson IK. Social participation in persons with upper limb amputation receiving an esthetic prosthesis. J Hand Ther. 2020;33(4):520-527.
• Rumsey N, Clarke A, White P, Hooper E. Investigating the appearance-related concerns of people with hand injuries. Br J Hand Ther. 2003;8(2):57-61.
• Sposato L, Yancosek K, Lospinoso J, Cancio J. Psychosocial reactions to upper extremity limb salvage: a cross-sectional study. J Hand Ther. 2018;31(4):494-501.
• Sposato L, Yancosek K, Cancio J. Psychosocial reactions to upper extremity limb salvage: a case series. J Hand Ther. 2019;32(1):48-56.
• Manske PR. Aesthetic hand surgery. J Hand Surg Am. 2002;27(3):383-384.
• Hall JA, Horgan TG, Murphy NA. Nonverbal communication. Ann Rev Psychol. 2019;70:271-94.
• Tocco I, Salini E, Bassetto F. Impact of hand injury on patients:psychosocially oriented nurse care. Int J Nurs Pract. 2011;17(3):275-279.
• Cederlund R, Jönsson ALT, Dahlin LB. Coping strategies in daily occupations 3 months after a severe or major hand injury. Occup Ther Int. 2010;17(1):1-9.
• Brown PW. Less than ten--surgeons with amputated fingers. J Hand Surg Am. 1982;7(1):31-37.
• Giladi AM, Ranganathan K, Chung KC. Measuring functional and patient-reported outcomes after treatment of mutilation hand injuries. A Global Health Approach. Hand Clin. 2016;32(4):465-475.
• Taber KS. The Use of Cronbach’s alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018;48:1273-1296.