Goal pursuit and goal adjustment as predictors of disability and quality of life among individuals with a lower limb amputation: a prospective study.

OBJECTIVE (1) To identify significant changes in disability and quality of life (QOL) across 3 time points (t1: admission to rehabilitation; t2: 6wk postdischarge; t3: 6mo postdischarge) in individuals with lower limb amputation, and (2) to examine whether goal pursuit and goal adjustment at t1 were predictive of these outcomes at t3. DESIGN Prospective cohort study. SETTING Inpatient rehabilitation. PARTICIPANTS Consecutive sample of persons (N=64) aged ≥18 years with major lower limb amputation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF). RESULTS Mean WHODAS 2.0 scores were in the 95th percentile at each time point. Scores on the WHODAS 2.0 and the physical, psychological, and social relations domains of the WHOQOL-BREF remained stable across the study period. Environmental QOL scores decreased from t1 to t2 but returned to near-baseline levels between t2 and t3. Having a greater tendency toward goal pursuit at t1 was predictive of higher physical and psychological QOL at t3, whereas having a stronger disposition toward goal adjustment at t1 predicted lower disability and higher environmental QOL at t3. CONCLUSIONS High levels of disability were experienced from admission to rehabilitation up to 6 months postdischarge. QOL in the physical, psychological, and social relations domains remained stable over the study period. Stronger goal pursuit and goal adjustment tendencies on admission predicted lower disability and higher QOL 6 months postdischarge.