Navigating life after amputation (NLAA): The development of a Wales-wide, online group supporting people living with amputation

Limb amputation causes myriad physical, social, and psychological consequences, negatively impacting wellbeing. However, structured psychological interventions for this population remain largely unexplored. In Wales, geographical distance from Artificial Limb and Appliance Centres (ALACs) and small local amputee populations further restrict access to support. To address these barriers, clinicians across the three ALACs developed the Navigating Life After Amputation course; an online, Acceptance and Commitment Therapy-based group to support amputees in improving their sense of wellbeing through increased psychological flexibility. This article outlines the development of this group. The group was co-produced with amputees and ALAC staff through focus groups, generating nine themes that shaped the course content. Seven amputees across the three sites completed screening and attended the online programme. Sessions included psychoeducation, skills practice, reflection, and peer discussion, alongside optional social time. Standardised measures of wellbeing (WEMWBS) and psychological flexibility (AAQ-II) were completed pre- and post-group, and attendees also provided qualitative feedback post-group. Five participants completed both sets of outcome measures. Mean WEMWBS scores increased (41 to 50.8), indicating a positive shift from low to mid-range wellbeing, while AAQ-II scores reduced (30.4 to 24), suggesting improved psychological flexibility. Qualitative analysis found three main themes: peer connection and emotional reassurance; a sense of safety and inclusivity; and increased confidence and personal growth. Although small and self-selected, this pilot suggests that a pan-Wales online ACT group is feasible, acceptable, and beneficial for amputees. The programme widened access for individuals with mobility and travel constraints, fostered cross-Health Board collaboration, and contributes some evidence supporting group-based psychological care within limb services. Mae torri aelod o’r corff i ffwrdd yn achosi llu o ganlyniadau corfforol, cymdeithasol a seicolegol, gan effeithio’n negyddol ar lesiant. Fodd bynnag, nid yw ymyriadau seicolegol strwythuredig ar gyfer y boblogaeth hon wedi cael eu harchwilio i raddau helaeth. Yng Nghymru, mae’r pellter daearyddol oddi wrth Ganolfannau Aelodau Artiffisial a Chyfarpar (ALACs) a phoblogaethau bach lleol o bobl sydd wedi colli braich neu goes yn cyfyngu ymhellach ar fynediad at gymorth. Er mwyn mynd i’r afael â’r rhwystrau hyn, datblygodd clinigwyr ar draws y tair Canolfan y cwrs Bywyd ar ôl torri aelod o’r corff i ffwrdd; grŵp Therapi Derbyn ac Ymrwymo ar-lein i gefnogi’r rhai sydd wedi colli coes neu fraich i wella eu hymdeimlad o les drwy fwy o hyblygrwydd seicolegol. Mae’r erthygl hon yn amlinellu datblygiad y grŵp hwn. Cafodd y grŵp ei gyd-gynhyrchu â phobl sydd wedi colli coes neu fraich a staff ALAC drwy grwpiau ffocws, gan greu naw thema a siapiodd gynnwys y cwrs. Fe wnaeth saith o bobl sydd wedi colli coes neu fraich ar draws y tri safle gwblhau’r broses sgrinio a dilyn y rhaglen ar-lein. Roedd y sesiynau’n cynnwys seicoaddysg, ymarfer sgiliau, myfyrio, a thrafodaeth rhwng cymheiriaid, ochr yn ochr ag amser cymdeithasol dewisol. Cwblhawyd mesurau lles wedi’u safoni (WEMWBS) a hyblygrwydd seicolegol (AAQ-II) cyn ac ar ôl y grŵp, a rhannodd y rhai a oedd yn bresennol adborth ansoddol ar ôl y grŵp hefyd. Cwblhaodd pum cyfranogwr y ddwy set o fesurau canlyniadau. Cynyddodd sgoriau cymedrig WEMWBS (41 i 50.8), sy’n dangos newid cadarnhaol o lesiant ystod isel i ganolig, tra bod sgoriau AAQ-II wedi gostwng (30.4 i 24), sy’n awgrymu gwell hyblygrwydd seicolegol. Canfu dadansoddiad ansoddol dair prif thema: cysylltiad â chyfoedion a sicrwydd emosiynol; ymdeimlad o ddiogelwch a chynwysoldeb; a mwy o hyder a thwf personol. Er ei fod yn fach ac wedi’i ddewis ei hun, mae’r cynllun peilot hwn yn awgrymu bod grŵp ACT ar-lein Cymru gyfan yn ymarferol, yn dderbyniol ac yn fuddiol i bobl sydd wedi colli coes neu fraich. Roedd y rhaglen yn ehangu mynediad i unigolion â chyfyngiadau symudedd a theithio, yn meithrin cydweithio ar draws Byrddau Iechyd, ac yn cyfrannu rhywfaint o dystiolaeth sy’n cefnogi gofal seicolegol mewn grwpiau o fewn gwasanaethau torri aelodau o’r corff i ffwrdd.