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The Value Filter: A Novel Framework for Psychosocial Adjustment to Traumatic Upper Extremity Amputation

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Abstract

Purpose Upper extremity traumatic amputation due to work injury is a devastating injury with poor outcomes. As it does not appear to follow existing theories of psychosocial adjustment to injuries and illness, we sought to understand this problem by asking those who have sustained the injury, how they try to adjust. Methods Qualitative methods were used to interview 11 participants within 3 years of their accident. Questions included “Tell me about the impact of the amputation on your life”. Data were systematically gathered and analyzed using a grounded theory (constructivist) approach which led to a preliminary model of adjustment. Results The Value of the Hand, and the Value of Working and Doing, emerged as central phenomena and created a Value Filter through which our participants’ new experiences were interpreted. Two interacting themes, Instability of the Core Identity, and Efforts to Stabilize the Self, describe the effects of the process which either interfered with or promoted the formation of new values that, in turn, could lead to adjustment. Conclusions The preliminary model helps explain psychosocial adjustment for individuals with a traumatic upper extremity amputation due to work injury. The model may also be useful with other acquired injuries where the lost body part was deemed highly valuable for the individual’s sense of self.

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Acknowledgements

We thank the participants in this study for sharing their experiences.

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Authors and Affiliations

  1. Holland Bloorview Kids Rehabilitation Hospital, 50 Kilgour Road, Toronto, ON, M4G 1R8, Canada

    Joanne Maxwell

  2. Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada

    Judith Friedland & Bonnie Kirsh

  3. Institute of Work and Health, 400 University Ave Suite 1800, Toronto, ON, M5G 1S5, Canada

    Dorcas Beaton

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  1. Joanne Maxwell
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  2. Judith Friedland
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  3. Bonnie Kirsh
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  4. Dorcas Beaton
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Correspondence to Joanne Maxwell.

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Ethical approval received from University of Toronto, Health Sciences Research Ethics Board and West Park Healthcare Centre/St John’s Rehabilitation Centre Joint Research Ethics Committee.

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Maxwell, J., Friedland, J., Kirsh, B. et al. The Value Filter: A Novel Framework for Psychosocial Adjustment to Traumatic Upper Extremity Amputation. J Occup Rehabil 32, 87–95 (2022). https://doi.org/10.1007/s10926-021-09976-5

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  • DOI: https://doi.org/10.1007/s10926-021-09976-5

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