Assessment of therapeutic education in 135 lower limb amputees.

OBJECTIVE: Therapeutic patient education (TPE) is a continuous process for chronic disease. TPE enables patients to improve and acquire the skills that are necessary for self-care and self-management. We wanted to determine the place of self-care in patients following lower limb amputation by evaluating prosthetic and limb management and prosthesis use.

MATERIAL/PATIENTS AND METHODS: To this aim, we involved 135 trans-tibial amputees between May 2011 and December 2013 who were fitted with contact silicone socket prosthesis with distal lock. Our patients were mainly amputated as a result of vascular disease, or diabetic complications. We assessed the patient's limb management, compression and level of experience in wearing their prosthesis. The TPE has been carried out with 95 patients because 13 patients died, 14 gave up the follow-up, 3 lived too far away and 10 who stopped wearing their prosthesis.

RESULTS: We found that the prosthesis was donned daily by 95 patients and that 52 patients wore the prosthesis more than 12hours per day. The self-management of complications was well acquired; only 10 patients suffered skin abrasions. The patients improved their own knowledge on several issues; autonomy of prosthesis donning for 78 patients, proper use of a prosthetic sock for 70 patients and assess proper fitting for 80 patients. Ninety-three patients walked inside with their prosthesis, 74 patients walked outside and 34 patients walked on any surface.

DISCUSSION - CONCLUSION DISCUSSION: The results of this study are functional data, they are subjective but represent the concrete expectations of the patient.

CONCLUSION: A TPE, adapted to the cognitive and functional capacities, led to fewer complications and to a higher autonomy and quality of life.