Quality and user satisfaction scores for prosthetic limbs provided in a fitting camp, Cambodia

Abstract

Objective: prosthetic limbs can enable mobility, independence and social participation. Fitting camps provide devices to many individuals in intensive sessions. This study addressed concerns regarding device design and fabrication at a fitting camp for 525 people in Cambodia.

Methods: we assessed device quality and satisfaction at prosthetic limb provision, and device usage and preference at 3-month follow-up.

Findings: many devices failed to meet International Society for Prosthetics and Orthotics standards for usage, workmanship, and client satisfaction. Interviews revealed dissatisfaction with function (26%), workmanship (34%), and fit (56%). At follow-up, 36% of clients reported discomfort or pain. 80% with a previous prosthesis preferred it. 81% reported not very often, rarely, or never using their new device, whereas 87% of clients with a previous device reported often or always using it. 29% were using a previous device observed at the camp as unused, broken, painful, or poorly fitting, suggesting many rely on an inadequate or potentially dangerous prosthesis.

Conclusion: these findings indicate that shortcomings in quality and satisfaction of the studied prosthesis system persist, and raise new questions about inclusiveness of patient selection and effectiveness of funding use in the intensive delivery format. Inadequate training and aftercare may exacerbate these issues, burdening local rehabilitation services or leaving vulnerable clients without support. Camps may be more appropriate when need is clearly demonstrated, should integrate fully with existing services, and provide adequate materials and components for repairs. Screening patients for need is essential, as is engaging the practitioners who will continue with their care.

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Identifiers

ORCID for Andrew Amos Channon: orcid.org/0000-0003-4855-0418

ORCID for Alex Dickinson: orcid.org/0000-0002-9647-1944

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