الفهرس 
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Abstract
Quality of life automatically drops after losing any important part of one’s body. Limb loss is a life-changing event that can cause significant disruptions in many important areas of existence. Although individuals with limb loss regardless of the type of disability are confronted daily with the positive and negative impact of their abilities, there are certain ramifications when individuals can never choose to feel invisible or take a break from their difference. Even positive attention focused on how they are able to operate within their disability can be emotionally taxing over time (Malik et al., 2012).
The use of prosthesis limb can have a significant impact on mobility, participation and psycho-social functioning of the amputees, there by influencing their quality of life. The support and encouragement of medical staff, friends and family can have a very powerful effect on the ability to heal from the consequences of limb loss and finalize the stages of grieving. In spite of the challenges with amputation, many people with limb loss do adapt to lead normal, productive, happy lives, working, enjoying hobbies, and raising families (Sinha and Heuvel, 2011).
Aim of the Study
The aim of this study is to assess the quality of life among adults with prosthesis limbs through:
1. Assessing knowledge of adults with prosthesis limb about prosthesis.
2. Assessing practices of adults with prosthesis limb about care and use of their prosthesis device.
3. Assessing the aspects of QOL (physical, social, psychological, and spiritual) for adults with prosthesis limb
Research Questions:
1. Is there relation between socio demographic characteristics of adults with prosthesis limb and their knowledge? ¬¬
2. Is there relation between socio demographic characteristics of adults with prosthesis limb and their practice? ¬¬
3. Is there relation between knowledge of adults with prosthetic limb and their practice about use and care of prosthesis limb?
4. Does the prosthetic limb affect on the aspect of QOL of adults with prosthesis limb (physical, social, psychological)?
Research Design:
Descriptive design was used in order to assess the quality of life among adults with prosthesis limbs.
Technical Design:
• Setting:
This study was conducted at the Physical Medicine and Rehabilitation and Rheumatology Center affiliated to armed force, located in Al-Geza governorate of Egypt: which is located in Al Agoza district. The center includes a factory for artificial limbs and rehabilitation accessories. This rehabilitation center contracted at 1954, it occupies the first place in Middle East for manufacture of prosthetic devices, serve all governorates in Egypt and provide rehabilitation program for persons with prosthesis limbs. The rehabilitation center provides services to all military and civilians personal.
• Sampling:
• A Purposive sample of 193 which represent 20% adults with prosthesis limbs were selected from total average number 975 case. 10 adults with prosthesis limbs were taken from total number for pilot study.
• Inclusion criteria: Adults with upper and lower prosthesis limbs, their age up to 20 years old and wearing prosthesis limbs at least from one year. .
• Tools of Data Collection:
One tool was used for data collection:
Structured Interviewing questionnaire, it was developed by the investigator based on the recent literature review and experts opinions which composed of (1-76) questions, in to five parts (Appendix):
Part I: Designed to assess the Socio-demographic characteristics of adults with prosthesis limb such as age, gender, residence, educational level, marital status, occupation and monthly income.
Part II: Assess adults with prosthesis limb’ medical history as regards chronic disease, causes, time, site and number of limb loss, types, duration of wearing prosthesis limb, health problem and follow up.
Part III: Designed to collect data of adults with prosthesis limb’ knowledge about prosthesis which included meaning, types, parts, complication, causes of limb loss, factors effect choice of prosthesis, treatment and prevention of health problems.
Part IV: Designed to assess adults with prosthesis limb’ practice related to residual limb and prosthesis care, it was adopted from Horgan and Maclachlan, (2010) and Davidson et al., (2011): It covered the following practices included daily cleaning, examination of prosthesis and residual limb, wearing and take off prosthesis and dealing with problems.
Part V: It was constructed to assess the quality of life for adults with prosthesis limb. This tool was adapted from Ali et al. (2010) and modified by the investigator.
The study results can be summarized as follows:
• The mean age of adults with prosthesis limbs was 40.27± 10.59 years and 65.3%, 60.6% were male and married respectively. Regarding educational level, 39.4% of them had secondary level of education and 63.2% of them had insufficient income.
• This study also reflected that 45.6% of them had satisfactory knowledge score level. 5.7% of them had satisfactory knowledge score level about problems with prosthetic limb.
• There were 100 % of studied sample had adequate practice regarding take off prosthetic limb, 74.6% regarding wearing of prosthetic limb, 32.6% regarding cleaning of prosthetic limb and 18.1% regarding examination of prosthetic limb.
• This study also clarifies that 48.7% of studied sample had poor physical quality of life, 72.5% of them had also poor psychological and economical quality of life. Also 51.8% had poor spiritual quality of life. Totally 55.4 % of the studied sample had poor quality of life.
• There was highly significant difference between age, marital status, educational level and Job of adult with prosthetic limb and their total knowledge about prosthetic limb.
• There was highly significant difference between marital status, educational level and job of adult with prosthesis limb and their total practice.
• This study also clarifies that there was highly significant difference between total knowledge of adults with prosthesis limbs and their total practice.
On the light of the finding of the present study, it can be concluded that:
There was highly statistically significant relation between knowledge of adults with prosthesis related to prosthetic limb and their age, educational level and. and Job. Also there was highly statistically significant relation between educational level, marital status and job of adult with prosthetic limb and their practice. This study reflected that there was a highly significant relation between knowledge of adults with prosthesis limb related to prosthetic limb and their practice. Finally, this study clarifies that more than half of adults with prosthetic had poor quality of life.
The finding of the present study, suggested the following recommendations:
1. Regular awareness program should be conducted regarding prosthesis limb its newer types, parts, complication and prevention of problem.
2. Guidelines or simplified booklet contain basic information about prosthetic limb and its care should be designed.
3. Appropriate intervention to decrease stress levels and anxiety to enhance quality of life among adults with prosthesis limb.
4. Further researches are required involving larger study sample of individual with prosthesis limb and their family at different study settings, throughout Egypt, in order to generalize the results