Grant: Travel Awards - Institute Community Support

Nearly 50,000 Lower Limb Amputations (LLAs) were performed in Canada from 2006-2011, leading to a substantial increase in demand for health services. Extensive rehabilitation is required to assist these clients in addressing decreased mobility and other conditions (e.g. depression, pain) associated with LLA. However, reduced healthcare investment (e.g. shorter lengths of stay for inpatients, move to outpatient services) requires new service delivery solutions. Unlike traditional rehabilitation, Self-Management (SM) programs teach people important coping skills and build their confidence and motivation so that they can self-manage disease-related physical and psychological challenges. These programs can be provided to clients through Mobile health technologies (mHealth) (e.g. smart phone or tablet), which are an equally novel method to providing services and can provide accessible, low-cost and, potentially, ongoing continuous rehabilitation after discharge in both urban and rural areas. We will conduct a 3-year, 3-phase mixed methods project. In Phase 1, we will use qualitative interviews to assess the needs and preferences of clients with LLA post-discharge from rehabilitation. In Phase 2, we will use a think-aloud approach to refine an online SM program, Self-Management for Amputee Rehabilitation using Technology (SMART), for clients with LLA aged >50 years in Canada. In Phase 3, we will conduct a pilot study to assess the applicability of SMART and its effect on clinical outcomes (depression, pain, self-efficacy, balance, mobility, physical activity). SMART has the potential to enable individuals with LLA to influence their needs for post-discharge from hospital surgical unit. Further, this SM program may provide direct (e.g. individual) and indirect (e.g. health system and caregiver) benefits. The results of this study will lead to the development and refinement of SMART, an SM program, which will inform a multi-site study to establish the usefulness of SMART.