Investigating experiences of clinicians working with partial hand prosthetics

BACKGROUND
Amputation of the wrist, palm or fingers of the upper limb is defined as partial hand amputation [1]. People with this condition may have difficulty carrying out tasks and activities, so they may benefit from using a prosthetic device. Others may use a prosthetic device for cosmetic reasons. While prosthetic technology is advancing, there are many people who choose not to use a device, abandon their device, or do not have device options available to them [2].

AIM
The objectives of the study were to survey experiences of partial hand prosthetics from the perspective of the workforce who develop, assess or prescribe them.

METHOD
An online survey was designed on Qualtrics to gain knowledge around the experiences of people who work with partial hand prosthetics. Survey questions included a selection of multiple choice, Likert-type scale, closed and open ended. Participants identified which devices and outcome measurement tools they had heard of and/or used. Participants were also asked about decision making processes and factors involved in device prescription. They rated factors of importance when assessing outcomes in the partial hand prosthesis user population. Analysis of data was carried out on Qualtrics.

RESULTS
In total, responses from 14 participants were collected. User satisfaction and comfort are most important when assessing outcomes. The most commonly used device amongst participants was cosmetic (93%) followed by opposition plate (64%). The majority of participants (79%) stated that they work with colleagues on decisions related to device prescription. The majority (79%) loan test units to users prior to prescription. Participants used a range of outcome measurements. A key theme in results was the impact of funding, and all participants stated that funding influences the range of partial hand devices available for them to work with. Common concerns were the cost of devices on the market and managing user expectations.

DISCUSSION AND CONCLUSION
Multiple stakeholders are involved in prescribing partial hand prosthetics. A range of factors such as funding, cost, user satisfaction and comfort must be taken into consideration when prescribing partial hands. Loaning test units is a beneficial and commonly implemented practice. There are no specified outcome measures designed or recommended for assessment of this population.

REFERENCES
1. Aspire - Prosthetics and Orthotics. "Partial Hand Amputation." https://aspirepo.com/services/prosthetics/partialhand-amputation/ (accessed 25 August 2021)
2. Biddiss E and Chau T. Upper limb prosthesis use and abandonment: A survey of the last 25 years. Prosthetics and Orthotics International 2007; 31: 236-257. DOI: 10.1080/03093640600994581