Quality and user satisfaction scores for prosthetic limbs provided in a fitting camp, Cambodia

Objective: To evaluate prosthetic devices delivered during an intensive fitting camp in Cambodia, considering device quality and client satisfaction. Methods: We conducted an observational cohort study in which we assessed prosthetic devices produced and delivered by an international nongovernmental organization at an intensive fitting camp. We conducted our assessment in two stages: at prosthetic device provision using a checklist to assess device quality and client satisfaction at discharge, and at 3-month follow-up using a telephone interview to assess the client's device usage and preference for a future device. Findings: We found that many of the devices fitted at the camp failed to meet International Society for Prosthetics and Orthotics' standards. Assessments revealed dissatisfaction with quality of work (33%; 175/525), fit (57%; 297/525) and function (26%; 139/525). At follow-up, 36% of clients (115/321) reported discomfort or pain. Most clients (78%; 238/305) stated preference for a domestically-produced device in future. Most clients (81%; 253/313) reported using their new device not very often, rarely or never, whereas 88% (243/277) of clients with a previous device reported using that device often or always. At least 29% (93/321) continued to use a previous device that they had described during the camp as unused, broken, painful or poorly fitting. Conclusion: Our findings indicate that shortcomings in quality and satisfaction of the studied prosthesis system persist as many clients rely on an inadequate or potentially dangerous prosthesis. The findings also raise new questions about client selection and the effective use of funding for the intensive camp provision format.