Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa

BACKGROUND: Major lower limb amputations result in a significant sense of loss, psychological stress, and decrease in function and overall quality of life for the amputee. The holistic, patient-centered prosthetic rehabilitation of an amputee requires input from a team of dedicated health professionals from different disciplines commonly referred to as a multidisciplinary team (MDT). MDT rehabilitation is considered crucial in the reintegration of the amputee into the community, as well as for providing psychological support after limb loss. Multidisciplinary and interdisciplinary rehabilitation has been proven to be more successful than therapy provided by individual therapists in a number of different populations, regardless of the population studied. However, in most developing countries, there is a significant lack of multidisciplinary rehabilitation. AIM: To explore the roles and challenges of the members of the MDT involved in trans-tibial amputation rehabilitation in a rural community in South Africa (SA). DESIGN: An explorative sequential qualitative descriptive study. SETTING: A rural district in the KwaZulu Natal province in SA. PARTICIPANTS: Nine prosthetic users, three surgeons, three traditional healers, 17 therapists, four prosthetists, and four community health workers. INSTRUMENTS FOR DATA COLLECTION: Semistructured interviews and focus group discussions. RESULTS: The roles of the members of the MDT were clarified, and various members of the MDT highlighted specific challenges relating to their experiences and roles in the rehabilitation team. Lack of interdisciplinary rehabilitation and communication among team members, as well as lack of resources, and patient education negatively impact the rehabilitation of trans-tibial amputees. CONCLUSION: Aiming to address the limited resources available to health care professionals, as well as improved communication and interdisciplinary rehabilitation, could potentially improve the overall rehabilitation of persons with a lower limb amputation in the rural setting.