Qualitative analysis of resilience characteristics of people with unilateral transtibial amputation.
Matthew J Miller, Meredith L Mealer, Paul F Cook and 3 others
PMID 32312526WHAT IT FOUND
People with leg amputation who reported higher resilience described using active coping, flexible thinking, optimism, risk appraisal, and social support to pursue goals.
Those with lower resilience reported passive coping, rigidity, avoidance, and limited support. Humor and exercise did not consistently emerge as key factors.
Key findings
01Five resilience characteristics (coping skills, cognitive flexibility, optimism, skills for facing fear, and social support) emerged consistently across participants, but were described differently by those with high versus low resilience scores.
02Participants with higher resilience scores described working through fear by appraising risks and benefits, whereas those with lower scores often avoided activities due to fear of failure or social stigma.
03Humor, role models, moral compass, altruism, and physical exercise did not consistently emerge as primary resilience characteristics in this group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was predominantly male (15 of 18) and included only unilateral transtibial amputations, limiting generalizability to women, bilateral amputees, or those with higher-level amputations. The study used a general population cut-point for the resilience scale because no specific cut-point exists for amputees, which may affect the accuracy of the 'resilient' vs 'low-resilient' grouping. The interviewer had a prior research relationship with one-third of the participants, which could influence the data despite efforts to minimize bias. The study describes associations between resilience characteristics and participant narratives; it does not prove that these characteristics cause better rehabilitation outcomes.
Declared interests
The authors declare no conflicts of interest. The study was supported by NIH and other government grants.
The easy way to misread this
Do not assume that teaching these five characteristics will improve outcomes. This study describes how resilient people talk about their experiences; it does not test an intervention. Also, do not expect humor or exercise to be the primary drivers of resilience for this specific group, as they did not consistently emerge in the narratives.