Background: Approximately 35% of the current population living with amputation is females. Furthermore, there are now an historic number of women serving in combat-related positions in the military. Women compose 15% of active duty military personnel and 18% of U.S. Army National Guard/Reserves personnel and now hold positions such as military police, gunners, medics, convoy transportation, intelligence, pilots, and mechanics, which put them in more direct combat experiences. Therefore, it is expected that there will be a sharp rise in the number of women who experience amputation related to combat. Despite these numbers, females with amputation are studied less than their male counterparts. What is known is that women are more likely to abandon their prosthetic device, which is due to both physical and psychosocial challenges. For example, most prosthetic devices and componentry are designed for men, but women generally require smaller prosthetic components. Not only does this lead to greater dissatisfaction with the prosthesis (both fit and appearance), it can also lead to other secondary problems, such skin breakdown and pain. The psychological impact of amputation in women has not been studied extensively either. One in five females Veterans screen positive for military sexual trauma and female Veterans are 22% more likely to be diagnosed with a mental health condition compared to male Veterans. As such, women with amputation face unique psychological challenges that need to be further studied so healthcare providers and clinicians can maximize satisfaction and quality of care. As such, more research is needed to fully determine the ways in which female amputees differ from male amputees, so the Department of Veterans Affairs (VA) and Department of Defense (DoD) can provide better care for this underserved population.

Objective: The primary objective of this proposal is to conduct an exploratory needs assessment of the unique impact of amputation on women, including physical, psychological, and social needs. We hypothesis that women living with amputation will have distinct physical, psychological, and social needs compared with men living with amputation.

Study Design: This study will be a 3-year investigation to create and distribute an online, electronic survey to determine the unique impact amputation has on women compared to men. One hundred female and 100 male Veterans, Service members, and civilians living with amputation from across the nation will be recruited from the VA, military treatment facilities, and private hospitals. Participants will be asked to complete an online computer adaptive survey regarding their physical health, quality of life, prosthetic use and needs, and psychosocial experiences. The survey is expected to take about 25-30 minutes to complete.

Application and Impact: There is a growing population of women living with amputations, specifically in the VA and DoD healthcare systems, yet little research has been performed to understand the unique needs of this population. Women tend to reject their artificial limbs (i.e., not use prosthetic devices) more frequently than men, thus challenging providers to address these unique needs that can vary from male counterparts. Healthcare providers for women with amputations, such as the VA and DoD, must evolve healthcare delivery, research practices, and work jointly with manufacturers who create prosthetic devices to meet the unique needs of women with amputation. As such, it is important to fully understand both the physical and psychosocial needs of women with amputation in order to provide clinicians and doctors with the knowledge they need to provide the best possible care for this demographic. The results from this study can be immediately used in the clinics at the VA, DoD, and private hospitals to begin affecting the care of women with amputation, immediately impacting the quality of life for these individuals.