[AVBC 2025] Amputee Support Group Befriending Service

Year Submitted: 2025
Published Date: 05 December 2025

Tags: Social Care, Intermediate and Long Term Care ＆ Community Care, Care Continuum, Informal Workforce Transformation, Patient, Workforce Transformation, Job Redesign, Upskilling

About this Content

Aims

This project strives to enhance social integration and reintegration in the community for persons with amputations (PWAs) via peer-befriending and personal empowerment. Identified befrienders are our former patients with amputation who are well-integrated in the community. The befrienders serve as peers, coaches and facilitators to encourage patient activation, with support and oversight provided by Allied Health professionals from TTSH and AMKCH, hence developing greater capacity of PWAs to form a sustainable self-help community. We offer regular trainings to equip befrienders with necessary knowledge and skills to work effectively with PWAs, and to improve consistency of service quality. In addition, we intend to upskill experienced befrienders to be trained as facilitators and mentor other new befrienders.

Background

Through clinical encounters, persons with amputation (PWA) shared that they experienced feelings of loneliness, uncertainty and isolation, compounded by the fact that there are limited opportunities to interact with person of similar profiles during their hospitalisation. While healthcare workers can provide professional knowledge and advice, receiving support from someone with limb loss can be reassuring.

Studies have reported better rehabilitation outcomes when newly amputated patients are provided with the opportunity to interact with someone who had been well-integrated into the community post-amputation. This allows them to have a better understanding about life with limb loss.

PWAs have lived experiences of these psychological reactions which they can empathize with other PWAs, this makes them good candidates to be befrienders to patients. By being a befriender, it also gives them sense of purpose to contribute to society, regain confidence and encourage people with limb loss to look beyond their physical impairment.

Methods

Our implantation plans are:
1. Recruit 4 new befrienders during the course of the project
2. Provide 2 training sessions for a period of 12 months for newly recruited befrienders (once every 6 months)
- To be completed by February 2021
- To be completed by August 2021
3. Conduct bi-annual feedback / refresher training
4. Identify 2 suitable befrienders with positive aptitude (who will need to complete at least 3 befriending sessions with a passing mark of 88 from Befriender Competency Assessment) and train them to be mentors
5. Establish bi-annual training platform for the mentors to facilitate training session with support from AHPs regarding feedback / improvement of coaching
6. Target 12 inpatient or outpatient befriending sessions for a period of 12 months from January 2021 to December 2021, in addition to 6 befriending sessions conducted in 2020.

Structured and robust training will be provided to the new and existing befrienders through a 2 hour video conference training with information on amputation, suicide risks as well as imparting knowledge on soft skills and assessing them via role plays. Identified befrienders will also receive training to be mentors for newly recruited befrienders.

Results

1. Number of newly recruited befrienders: 3 out of 4 befrienders were recruited. Only 1 befriender completed all training required.

2. Number of identified befrienders to become facilitators: 0 out of 2 befrienders identified to become facilitators were trained.

3. Befriending sessions completed: 7 sessions from January 2021 to December 2021, 6 sessions from January 2020 to December 2020.

4. Befriender competency assessment: 100% passing rate for all befriending sessions

5. Patient self-reported feedback regarding befriending sessions: 100% positive self-reported feedback received from PWAs for all befriending sessions.

Conclusion

Visitors restriction policies implemented in TTSH and AMKCH because of Covid-19 social distancing policy stalled face-to-face befriending sessions by Amputee Support Group befrienders to patients who have newly undergone amputation since February 2020 till date. The team improvised and implemented tele-befriending service instead.

With tele-befriending sessions, the befriender would not be able to show their stump and prosthesis to the PWA. To overcome this, the befrienders would share their personal rehabilitation videos prior to the befriending sessions with the person with amputation for his reference.

The project is managed by allied health professionals from TTSH and AMKCH, who are also required to meet their departments operational needs during working hours. It was challenging to find replacement for staff who may be away for prolonged period, such as on maternity leave or no-pay leave. Due to the unpredictability of befriending sessions, it was not possible to hire locum on ad-hoc basis to manage this programme. The limit on manpower support restricts team members from focusing on project management with the planned timeline, due to their professional operational needs to meet as well.

Lessons Learnt

Previously, the project focuses strongly on delivering befriending services through face-to-face befriending sessions, as well as face-to-face training sessions for new befrienders. However, due to the current Covid-19 situation, alternative mode of distance befriending services has been considered in place of face-to-face befriending sessions, such as tele-befriending sessions, in lieu of social distancing policy. Training and observation of tele-befriending sessions were conducted for the befrienders to familiarise with the use of technology during the tele-befriending session.

To engage and show appreciation for the befrienders, the team adopted a virtual social bonding event, as well as preparing care packs for the befrienders. This is important for retainment of the befrienders in the programme and to feel valued for their participation.

Our team recognises that for project management, it is important to keep track of the following to monitor progress and ensuring claims and completion of feedback were done.

Additional Information

This project is funded by the Centre for Allied Health and Pharmacy Excellence (CAPE).

Keywords

Empowerment, Patient Activation, Befrienders, Persons with Amputations

Innovators' Details

Connect with this contributor!

CAPE: Centre for Allied Health & Pharmacy Excellence - cape@nhghealth.com.sg

Project Attachment

936_TTSH, AMKCH_CAPE FY19_Amputee Support Group Befriending Service.pdf