Quality of Medical Care Provided to Service Members with Combat-Related Limb Amputations: Report of Patient Satisfaction

By Pasquina, Paul F.; Tsao, Jack W. et al. | Journal of Rehabilitation Research & Development, September 2008 | Go to article overview

Quality of Medical Care Provided to Service Members with Combat-Related Limb Amputations: Report of Patient Satisfaction


Pasquina, Paul F., Tsao, Jack W., Collins, Diane M., Chan, Brenda L., Charrow, Alexandra, Karmarkar, Amol M., Cooper, Rory A., Journal of Rehabilitation Research & Development


INTRODUCTION

The advancement of medical knowledge, especially rehabilitation services, historically has been associated with times of war [1-3]. The disciplines of physiatry, physical and occupational therapy, rehabilitation engineering, and vocational rehabilitation were largely formed in response to the needs of injured soldiers returning from the first and second World Wars [2-5]. Technological advances in assistive devices, such as wheelchairs, prostheses, and orthoses, were largely discovered to improve the lives of veterans with paralysis and limb loss [4-6]. Further, the determination of many veterans with disabilities to return to highly active lifestyles has greatly contributed to improved access of all individuals with disabilities to sports and recreation [7-8].

Since the United States began its efforts in the global war on terrorism (GWOT) in 2001, 737 military service members as of January 1, 2008 have sustained major limb amputations associated with military operations in Iraq and Afghanistan [9]. Most (n = 540, 73.3%) of these service members have been treated in Washington, DC, at Walter Reed Army Medical Center (WRAMC), a healthcare center that offers a highly structured and interdisciplinary program of care for individuals with amputations. Providers from multiple services, such as surgical, medical, and rehabilitation specialties, are integrated with psychosocial support groups, vocational counselors, peer visitors, recreational and sports groups, and various other public and private organizations to deliver the highest quality of care. The remaining service members were treated at Brooke Army Medical Center in San Antonio, Texas, and at the Naval Medical Center San Diego in San Diego, California. The study reported in this article was conducted solely at WRAMC.

Patient satisfaction is one of the most vital quality outcome measures in the assessment of the performance of healthcare systems and personnel [10]. Previously used as a management tool by the Department of Defense (DOD), satisfaction surveys assess patient satisfaction with the healthcare services provided [11-12]. Similarly, the WRAMC Amputee Clinic has established multiple methods of evaluation and feedback to improve and maintain the excellence of its services. Quality outcomes have been established for several domains of medical, surgical, and rehabilitative care and, in particular, the peer component of all aspects of recovery. To ensure quality of inpatient care and promote performance improvement, the staff of the Physical Medicine and Rehabilitation Service at WRAMC created a Quality of Care (QoC) Questionnaire to administer to service members during their initial outpatient visits to the WRAMC Amputee Clinic. This survey contained 23 questions on key aspects of medical and rehabilitative care (i.e., psychological support, pain management, medical care, education, and accommodations); each question was rated on a 10-point Likert scale [13]. Questions focus on the period of time from the service member's initial injury to his or her discharge from inpatient services at WRAMC.

This study analyzed satisfaction ratings on the various aspects of medical and rehabilitative care provided to military service members who sustained limb amputations during military operations in the GWOT. In particular, the survey investigated the importance of support and peer groups in the treatment of patients with amputations. While the Department of Veterans Affairs (VA)/DOD practice guidelines for rehabilitation suggest use of peer support groups as a rehabilitation method, other studies make stronger claims about the import of such peer groups.* One study that investigated the importance of peer visitation found the visitations to have even greater impact than education [14], while others researchers indicated that peer groups enabled patients to better cope with depression, fear, and helplessness [15-16].

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Quality of Medical Care Provided to Service Members with Combat-Related Limb Amputations: Report of Patient Satisfaction
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.