300 Section - Assessment of social inclusion, discrimination, and symptoms of anxiety and depression in individuals with lower-limb amputation

Objectives : The study aims to determine the relationship between social inclusion and emotional aspects in individuals with lower-limb amputation in comparison to people without disabilities. Secondarily, the study aims to assess the impact of social discrimination on the occurrence of anxiety and/or depressive symptoms, and to assess the impact of prosthesis use on social inclusion.

Design: Epidemiological, observational, cross-sectional, and quantitative study conducted with individuals with lower-limb amputation undergoing treatment at a public health rehabilitation center, as well as with their peers without disabilities. Social inclusion was measured using the Social and Community Opportunities Profile (SCOPE-B), emotional aspects were assessed using the Hospital Anxiety and Depression Scale (HADS), and social discrimination was evaluated with the Explicit Discrimination Scale (EDS).

Results: The sample consisted of 100 participants (50 with lower-limb amputation and 50 controls without disabilities). There was a predominance of males (84%), higher age in the amputation group (52.5 vs. 43.6 years; p = 0.012), and lower education and income levels. Being an amputee was 5.9 times more likely to be associated with social exclusion compared to individuals without disabilities (p = 0.02). The amputation group showed lower social inclusion and satisfaction, accompanied by higher levels of anxiety and depression. Regression analyses indicated that lower social inclusion scores increased the likelihood of anxiety and depression symptoms in both groups (amputees and controls). Probable anxiety classifications were associated with a 31.6-fold increased risk of social exclusion, while higher depressive symptom scores were associated with a 27-fold increased risk. Perceived discrimination correlated with psychological distress only in the amputation group. Prosthesis use was not associated with social inclusion.

Conclusion: Within the current socioeconomic context, amputation is associated with increased social exclusion. Emotional factors are linked to social exclusion, and experiences of discrimination exacerbate psychological distress. Prosthesis use did not appear to enhance social inclusion.