下肢丧失的人,尤其是血管异常的病因,同侧和对侧截肢都有很大的风险。此外,虽然没有很好的记录,人们认识到截肢发生率不仅受性别等社会人口统计学因素的影响,种族,社会经济地位,还受服务接入等系统因素影响。在肢体丧失康复领域解决这种差异的系统策略是使肢体丧失康复计划(LRP)与医学专家合作,心理健康专业人士,和肢体保存计划(LPP),以提供全面的肢体护理。虽然LPP存在于全国各地,此类计划的设计原则及其与LRP的伙伴关系作用尚未确立。使用社会生态模型纳入肢体护理多学科领域固有的分层利益相关者观点,这篇综述综合了最新的证据,专注于LPP的设计和实施原则,这些原则可以帮助决策者,医疗保健组织和失肢康复和肢体保护专业人员的发展,工具,并与LRP合作维持强大的LPP计划。
People with lower limb loss, especially of dysvascular etiology, are at substantial risk for both ipsilateral and contralateral reamputation. Additionally, while not as well documented for reamputation, there is recognition that amputation incidence is influenced by not only sociodemographic factors such as sex, race, socioeconomic status, but also by system factors such as service access. A systems strategy to address this disparity within the field of limb-loss rehabilitation is for Limb-loss Rehabilitation Programs (LRP) to partner with medical specialists, mental health professionals, and Limb Preservation Programs (LPP) to provide comprehensive limb care. While LPPs exist around the nation, design principles for such programs and their partnership role with LRPs are not well established. Using a socioecological model to incorporate hierarchical stakeholder perspectives inherent in the multidisciplinary field of limb care, this
review synthesizes the latest evidence to focus on LPP design and implementation principles that can help policymakers, healthcare organizations and limb-loss rehabilitation and limb-preservation professionals to develop, implement, and sustain robust LPP programs in partnership with LRPs.