Psychological components of vocational guidance for individuals with traumatic lower limb amputation due to combat injury at the stages of medical rehabilitation

Background. Psychological factors that influence the vocational guidance of patients with traumatic lower limb amputations due to combat injuries are a highly significant and relevant research area. Implementing measures aimed at orienting patients to work activities at an early stage allows for continuity between the medical and social stages of rehabilitation. Additionally, these patients become self-motivated to undergo treatment as a means of returning to work.

Objective: To identify the characteristics of vocational interests and motivation in patients with combat-related lower limb amputations who are undergoing the second stage of medical rehabilitation.

Material and methods. The study included 850 individuals who participated in the Special Military Operation. Following surgical treatment for combat wounds that resulted in the traumatic amputation of their lower extremities, the patients entered the second stage of medical rehabilitation. Designed as part of a comprehensive rehabilitation program, this stage took place at the Goluboe Medical Scientific and Practical Center of the Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical and Biological Agency. All participants had sustained combat-related injuries resulting in traumatic lower limb amputation and had completed the surgical phase of treatment. The age of respondents ranged from 19 to 64 years (37.8±10.9 years). Methods included Gerchikov motivation test, an express method for identifying sports motivation (developed by G.V. Lozovaya), and the test of vocational interests/inclinations by L.A. Yovaisha, as modified by G. Rezapkina. Additionally, cluster analysis (K-means) and Student's t-test were employed.

Results. Two types of motivation were identified: low (Cluster 1) and high (Cluster 2) overall motivational levels. They differed primarily in the extent to which the patients assessed their motivation toward various aspects of activity. Motivation to engage in physical therapy exercises or walking is the primary type of activity in rehabilitation programs. Therefore, the level of motivation in these activities can affect perceptions and aspirations regarding professional employment (based on the unity of mental life assumption). Patients in Cluster 2 demonstrate higher scores on the Professional, Patriotic, and Master (оwner) scales. These findings may serve as a foundation for developing individualized vocational guidance programs. Patients in Cluster 1 tend to exhibit Lumpenized motivation, defined as a passive attitude, minimal work effort, and avoidance of responsibility.

Conclusion. In the long term, vocational guidance support programs may contribute to the successful resocialization of combat veterans. Furthermore, implementing vocational guidance activities during the medical stage of rehabilitation facilitates an individualized approach to patients while introducing the concept of future professional fulfillment.

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