Feminine identity and functional benefits are key factors in women's decision making about upper limb prostheses: a case series.

PURPOSE: Although the DEKA Arm promises new abilities, it is unclear if women with upper limb amputation are willing to avail themselves of this new technology. The study purpose was to understand key factors and tradeoffs that shape women's attitudes towards the DEKA Arm.

METHODS: This case series includes three women with transradial amputation. Structured surveys and semi-guided interviews were administered after completion of in-laboratory training and a home trial of the DEKA Arm. A constant comparative method with a grounded theory approach was used to generate a model describing women's decision-making related to the DEKA Arm. Quantitative data on prosthetic satisfaction was used to triangulate findings.

RESULTS: Factors that enhanced desirability of the DEKA Arm were improved functionality, increased abilities and the availability of someone to service the prosthesis. Factors that detracted from desirability of the device were its appearance, conspicuousness, lifestyle incompatibility, weight, need for service and difficulty of use. Each woman weighted these factors within the larger context of the capabilities of and satisfaction with her personal prostheses, her self-concept and lifestyle needs. Situational demands, particularly the desire to appear feminine and professional or need to perform certain activities, also altered the valuation of these priorities.

CONCLUSION: Findings strongly suggest that advanced upper limb prosthetic technologies, like the DEKA Arm, will be better accepted by women if appropriately gendered in appearance and designed with women's priorities in mind. Implications for Rehabilitation Women should be able to derive the functional benefits of advances in upper limb technology without needing to compromise their feminine identity and lifestyle preferences. Advanced upper limb prosthetic technologies will be better accepted by women if they are appropriately gendered.