Testing the Effects of the E-Health Amputee Patient Empowerment Program (EAPEP)

Abstract

Purpose: Advances in medical care and improvements in body armor have led to more soldiers surviving high-energy penetrating battle injuries. Between 2001 and 2015, 1,645 amputations occurred from military conflicts. Web-based programs may provide supplemental resources regarding physical rehabilitation and reintegration into life. Comprehensive health information and resources can assist optimal recovery. There is a lack of comprehensive websites dedicated to empowering amputees' self-management throughout the recovery phase. The study aim was to develop a theory-based e-health website, the E-Health Amputee Patient Empowerment Program (EAPEP), and to examine the preliminary impact of the EAPEP on empowerment, self-efficacy, and health-related quality of life. Design: Two group pre-test and post-test randomized control trial design. Methods: The EAPEP is comprised of objectives, an educational content section, knowledge assessment questions, and a coordinator-moderated blog area. Experimental group participants accessed the program twice each week for eight weeks. No intervention was provided to the control group. Amputee soldiers were recruited from Walter Reed National Military Medical Center (WRNMMC). Data were collected at baseline and after eight weeks. Data were analyzed using descriptive statistics and a Mann-Whitney U Test. Findings: The original target sample size (N=60) was not obtained due to low combat-injured census during the study recruitment period. Eighteen participants completed the pretest and were randomized to the intervention group (n=9) and control group (N=9). The mean age for subjects was 39 (SD=17.9), all subjects were male, 77.8% were lower limb amputation, and 33.4% were injured by Improvised Explosive Device (IED) and mortars, 61% were in the Army, 38.9% were Officers, and 83.3% were active duty. The mean post-test Health Education Impact Questionnaire empowerment scores were found to be higher for subjects in the intervention group, although the difference was not statistically significant. Self-efficacy for managing chronic disease and quality of life change scores were higher for subjects in the intervention group, although not statistically significant. Conclusion/Implications: E-health can be a cost-effective approach to deliver high standard of care globally and can be incorporated into treatment protocols. Research with larger sample sizes is needed. A modified program for other types of amputees and injuries should be employed.