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Social Support

 

How Can Your Social Relationships Change After Hand/Arm Transplantation?

Social considerations during the decision-making process

  • Some people may feel that their upper limb loss damages their body image or self-image, leading them to feel self-conscious during social interactions. 1-6

  • Some people may want to pursue hand/arm transplantation to reduce public attention and improve their social interactions. 7,8

  • If people expect that the hand/arm transplant will help them improve their social interactions, they need to clearly communicate this expectation (along with other expectations) to their health care providers. This can help ensure that their expectations align with their treatment goals and are attainable. 9-11

  • It is important for people considering hand/arm transplantation to feel that their social network is listening to their treatment goals and be careful when members of their social network try to persuade them to do something they are not comfortable with.
 

Angie Duckworth, Transplant Social Worker, talks about the importance of having good social support when pursuing a hand/arm transplant.

 

Why is it Important to Have a Strong Social Network Before and After Hand/Arm Transplantation?

The presence of strong, supportive social networks (e.g., transplant team, family, and friends) can positively affect hand/arm transplant recipients’ health practices and health outcomes.¹² Recipients with a supportive social network are more likely to:

  • Take prescribed medications as directed
  • Participate fully in their rehabilitation following surgery
  • Attend their health care appointments
  • Accept their hand/arm transplant as part of their body and identity

Hand/arm transplant recipients will more easily accept the hand/arm transplant as part of their body and identity if the people closest to them respond with positive feedback. 7,13-16

 

References

Sources

  1. Bradbury E. The Psychological and Social Impact of Disfigurement to the Hand in Children and Adolescents. Developmental neurorehabilitation 2007;10(2):143-148.

  2. Cohen S, Wills TA. Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin. 1985;98(2):310-357.

  3. Haggerty RJ. Life Stress, Illness and Social Supports. Developmental Medicine & Child Neurology 1980;22(3):391-400.

  4. Kumnig M, Jowsey-Gregoire SG, Rumpold G, et al. The Psychological Assessment of Candidates for Reconstructive Hand Transplantation. Transplant International 2012;25(5):573-585.  

  5. Rumsey N. Body Image and Congenital Conditions with Visible Differences. In: Cash TF & Pruzinsky T, eds. Body Image: A Handbook of Theory, Research, and Clinical Practice. New York: Guilford, 2002:226.

  6. Schwartzer R. Self-efficacy in the Adoption and Maintenance of Health Behaviours: Theoretical Approaches and a New Model. In: Schwartzer R, ed. Self-efficacy: Thought Control of Action. Washington: Hemisphere, 1992:217.

  7. Benedict JL. Vascularized Composite Allotransplantation. In: Weisstub DN, Cooley DR, eds.  A Revised Consent Model for the Transplantation of Face and Upper Limbs: Covenant Consent. Cham, Switzerland: Springer, 2017: Ch 2.

  8. Jensen SE, Butt Z, Heinemann AW, et al. Perceptions of the Risks and Benefits of Upper Limb Transplantation Among Individuals with Upper Limb Amputations. Plastic and Reconstructive Surgery 2014;134(5):979-987.  

  9. Klapheke MM. Transplantation of the Human Hand: Psychiatric Considerations. Bulletin of the Menninger Clinic 1999;63(2):159-173.

  10. Kumnig M, Jowsey-Gregoire SG, Moreno E, et al. An Overview of Psychosocial Assessment Procedures in Reconstructive Hand Transplantation. Transplant International 2014;27(5):417-427.  

  11. Petruzzo P, Lanzetta M, Dubernard JM, et al. The International Registry on Hand and Composite Tissue Transplantation. Transplantation. 2010;90(12):1590-1594. 

  12. Van Pilsum Rasmussen SE, Ferzola A, Cooney CM, et al. Psychosocial factors and medication adherence among recipients of vascularized composite allografts. SAGE Open Med. 2020;8:2050312120940423.

  13. Crawford CS. Body Image, Prostheses, Phantom Limbs. Body & Society 2015;21(2):221-244.

  14. Dickenson D, Widdershoven G. Ethical Issues in Limb Transplants. Bioethics 2001; 15(2): 110-124.

  15. Kumnig M, Jowsey-Gregoire SG. Key Psychosocial Challenges in Vascularized Composite Allotransplantation. World J Transplant 2016;6(1):91.  

  16. Slatman J, Widdershoven G. Hand Transplants and Bodily Integrity. Body & Society. 2010;16(3):69-92.