who had amputation secondary to blood clots and in those who experienced more preamputation pain and pain in the stump following amputation.
Disability following amputation is believed to be greater for below-the-knee amputations than above-the-knee amputations. Little empirical data has been found to substantiate this belief.
The continuum of care for health conditions can be grossly divided into acute conditions and chronic conditions. Chronic conditions that require continuous intervention for the same medical problems include rehabilitation services. Rehabilitation is defined as goal oriented interventions designed to develop individuals to their fullest physical, psychological, social, vocational, and educational potential. Psychologists have significant opportunities in each of these domains. In addition, the evolving “post-acute” sector of care that focuses on the integration of an individual into the community following the disabling conditions offers many role opportunities for psychologist.
Rehabilitation requires a broad range of psychological skills ranging from the treatment of more common psychopathological disorders to health psychology intervention to family and marital treatment. System issues are of critical importance in rehabilitation. Both the treating milieu, including the reactions of the rehabilitation staff, the family, and the individual are critical in determining the outcome. Psychologists working in rehabilitation must be knowledgeable of systems interventions and proficient in understanding both the social psychology and the clinical psychology of disability. Increasingly, psychologists in rehabilitation are designing interventions that collate interventions at the individual, family, and community level. At the same time, these interventions also are often sensitive to the diminishment of health resources and to maintaining the individual at the highest level of individual function. Rehabilitation and the chronic sector of care offer an important paradigm for the delivery of psychological services as the number of individuals with disabilities increases in the United States. Delivery systems such as the “cardinal symptom approach” that focus on the most disabling health concerns offer psychologists opportunities to create primary care delivery roles in which they provide continuous, comprehensive, coordinated service to individuals. Although this model may defy traditional definitions of primary care, as health care delivery systems evolve to meet the needs of consumers, traditional definitions will fall by the wayside.
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