Self Managing the Consequences of Major Limb Trauma. Revision

Abstract : The objective of this research is to develop and pilot a computer-based self management program (heretofore referred to as the NextSteps Program) for reducing secondary conditions and improving function following major lower limb trauma. The intervention was built on widely accepted self-management programs developed for persons with arthritis as well as components of a face-to-face self-management program for civilians with long-standing limb loss. It was necessary, however, to tailor the content and delivery of these programs to better accommodate the needs of a young, acutely injured population. Specific needs not typically addressed in the existing programs include the management of acute anxiety and post-traumatic stress disorder (PTSD), and the maintenance or acquisition of employment or return to active duty. Specific aims (revised in April 2009) of the project are: (1) to pilot the face-to-face self-management program for persons sustaining major limb trauma and refine the intervention based on feedback; (2) to develop on online version of the self-management program for persons sustaining major limb trauma (heretofore referred to as Next Steps); (3) to evaluate the feasibility and acceptability of the Next Steps program in 12-15 civilians treated at a large, Level I trauma center; and (4) to engage our military colleagues and service members as advisors to assist us in modifying the content of the Next Steps Program for service members and veterans. We will not have sufficient funds remaining at the end of the project period to fully develop and test the military version of NextSteps at Walter Reed as originally planned. However, we will produce a detailed plan for modifying the program in the future.