Associations Between Pain Characteristics and Adaptation in Veterans with Lower Limb Amputations

Abstract

Background: Pain is a multifaceted phenomenon that involves sensory, emotional, cognitive, and behavioral dimensions. Post-amputation pain not only compromises patients’ physical functioning but also adversely influences their psychological well-being, social life, and overall quality of life. Adjusting to life after an amputation is therefore a complex, multidimensional process that requires careful attention to multiple aspects of human experience. Objectives: The present research was conducted to investigate the associations between different types and intensities of pain and the adaptation level based on the Roy Adaptation Model (RAM) in veterans with lower limb amputations. Methods: A descriptive-analytical study was conducted among 76 veterans supported by the Martyrs and Veterans Affairs Foundation in Abadan, Iran. Participants were selected through purposive sampling. Data were gathered using demographic questionnaires, the McGill Pain Questionnaire (MPQ), and the RAM Questionnaire. The collected data were analyzed with SPSS version 26. Results: The greatest mean pain intensity was observed in the low back region (6.4 ± 2.1), while the lowest was reported in the toes (1.9 ± 1.7). The mean total pain score was 40.8 ± 12.7, indicating a moderate-to-high intensity of pain. The mean total adaptation score of participants was 63.5 ± 11.2, reflecting a moderate level of adaptation. The total pain score showed a significant negative correlation with all adaptation dimensions and with the overall adaptation score (R = -0.51, P < 0.001). Analysis of age revealed a significant negative correlation with total adaptation (R = -0.29, P = 0.01). Similarly, amputation duration demonstrated a significant negative correlation with total adaptation (R = -0.23, P = 0.04), indicating that veterans with longer histories of amputation reported lower levels of adaptation. Conclusions: The findings indicate that the pain experienced by veterans with lower limb amputations extends beyond physical aspects to include emotional, cognitive, and psychological dimensions, all of which considerably influence their overall adaptation. Designing educational programs, implementing pain management strategies, ensuring regular follow-ups, strengthening vocational rehabilitation, and promoting greater social participation may enhance adaptation and help reduce chronic pain among veterans.