{"doi":"10.1002/pmrj.12464","title":"Self‐Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower‐Limb Amputation","abstract":"BACKGROUND: Interventions targeting psychosocial factors may improve rehabilitation outcomes for prosthesis users after lower-limb amputation (LLA), but there is a need to identify targeted factors for minimizing disability. OBJECTIVE: To identify psychosocial factors related to disability for prosthesis users after LLA in middle age or later. DESIGN: Cross-sectional study. SETTING: General community. PARTICIPANTS: Participants with LLA (N = 122) were included in this cross-sectional study if their most recent LLA was at least 1 year prior, they were ambulating independently with a prosthesis, and they were between 45 and 88 years old. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Disability, the primary outcome, was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS). Candidate psychosocial variables included self-efficacy, social support, and motivation, measured using the Self-Efficacy of Managing Chronic Disease questionnaire (SEMCD), Multidimensional Scale of Perceived Social Support questionnaire (MSPSS), and modified contemplation ladder (mCL), respectively. The hypothesis was that greater self-efficacy, social support, and motivation would be associated with lower disability when controlling for covariates. RESULTS: The covariate model, including etiology, age, sex, U.S. military veteran status, LLA characteristics, time since LLA, medical complexity, and perceived functional capacity, explained 66.1% of disability variability (WHODAS 2.0). Backward elimination of candidate psychosocial variables stopped after removal of motivation (P = .10), with self-efficacy (P < .001) and social support (P = .002) variables remaining in the final model. The final model fit was statistically improved (P < .001) and explained an additional 6.1% of disability variability when compared to the covariate model. CONCLUSIONS: Greater self-efficacy and social support are related to lower disability after LLA. Findings suggest there may be a role for interventions targeting increased physical function, self-efficacy, and social support for ambulatory prosthesis users after LLA in middle age or later, especially when complicated by multiple chronic conditions.","journal":"PM&R","year":2020,"id":76073,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":22,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9547,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":340240,"name":"Paul Cook","orcid":"0000-0001-7791-9072","position":1,"is_corresponding":false},{"id":344776,"name":"Dawn Magnusson","orcid":"0000-0001-9344-4011","position":2,"is_corresponding":false},{"id":340241,"name":"Megan A. Morris","orcid":"0000-0002-0386-992X","position":3,"is_corresponding":false},{"id":267872,"name":"Patrick J. Blatchford","orcid":"0000-0003-1714-7263","position":4,"is_corresponding":false},{"id":398520,"name":"Margaret Schenkman","orcid":null,"position":5,"is_corresponding":false},{"id":340242,"name":"Cory L. Christiansen","orcid":"0000-0001-5549-5010","position":6,"is_corresponding":false},{"id":275985,"name":"Matthew J. Miller","orcid":"0000-0002-1301-7149","position":0,"is_corresponding":true}],"reference_count":48,"raw_metadata":null,"created_at":"2026-07-18T21:47:46.469293Z","pmid":"32926546","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}