A study of the person with limb loss viewing self in the mirror: First experience

Research Objectives: 1. To describe the trajectory of emotions with viewing self in a mirror after an amputation 2. To determine participants’ perceptions on what health care professionals should/do know about mirrors. 3. To identify sensitive and appropriate interventions that can be implemented to ease the psychological impact.

Design: Patients were recruited using flyers in an outpatient clinic to conduct a focus group. Inclusion criteria included: adults at least 18 years of age; had an amputation of an upper or lower limb; and ability to speak, read, and understand English

Setting: Five focus group of 3-6 individuals were conducted in a hospital setting and one 1:1 interview. Participants: 17 participants, including eight men and nine women, ages 19-68 years participated

Interventions: The groups (60-90 minutes) were audiotaped and transcribed verbatim and included a moderator who facilitated the groups with a semi-structured questions and an assistant that took notes and managed the environment.

Main Outcome Measures: This study questions how physical therapists and other health professionals consider the impact on how mirrors are introduced with caring for someone who has an amputation. This is a qualitative study and phenomenological interpretation was used using a focus group analysis.

Results: The viewing self in a mirror had four key themes: mirror shock, mirror anguish, recognizing self, and acceptance of a new normal. Most verbalized difficulty viewing their new body image for the first time and identified the need for sensitive clinical interventions

Conclusions: The goal of this study is to provide physical therapists with an understanding of initial viewing in a full length mirror after losing a limb. There is a need for both small and full-length mirrors for different purposes. Key findings are that those with limb loss need to be supported in the initial viewing of their changed bodies. Therapists need to realize that this may be an emotionally difficult experience and that their first viewing may need to take place in a private setting and have additional psycho- logical support available.