Purpose Upper extremity traumatic amputation due to work injury is a devastating injury with poor outcomes. As it does not appear to follow existing theories of psychosocial adjustment to injuries and illness, we sought to understand this problem by asking those who have sustained the injury, how they try to adjust. Methods Qualitative methods were used to interview 11 participants within 3 years of their accident. Questions included “Tell me about the impact of the amputation on your life”. Data were systematically gathered and analyzed using a grounded theory (constructivist) approach which led to a preliminary model of adjustment. Results The Value of the Hand, and the Value of Working and Doing, emerged as central phenomena and created a Value Filter through which our participants’ new experiences were interpreted. Two interacting themes, Instability of the Core Identity, and Efforts to Stabilize the Self, describe the effects of the process which either interfered with or promoted the formation of new values that, in turn, could lead to adjustment. Conclusions The preliminary model helps explain psychosocial adjustment for individuals with a traumatic upper extremity amputation due to work injury. The model may also be useful with other acquired injuries where the lost body part was deemed highly valuable for the individual’s sense of self.

目的因工伤导致的上肢外伤性截肢是一种毁灭性的损伤，预后不良。由于它似乎没有遵循现有的对伤害和疾病进行心理社会调整的理论，我们试图通过询问那些遭受伤害的人，他们如何尝试调整来理解这个问题。方法采用定性方法对事故发生后 3 年内的 11 名参与者进行访谈。问题包括“告诉我截肢对你生活的影响”。使用扎根理论（建构主义）方法系统地收集和分析数据，从而形成初步的调整模型。结果手的价值，以及工作和做事的价值，作为中心现象出现，并创造了一个价值过滤器，通过它我们的参与者的新体验得到了解释。两个相互作用的主题，核心身份的不稳定性和稳定自我的努力，描述了干扰或促进新价值观形成的过程的影响，而新价值观的形成反过来又可能导致调整。结论初步模型有助于解释因工伤导致创伤性上肢截肢的个体的心理社会适应。该模型也可用于其他获得性损伤，其中丢失的身体部位被认为对个人的自我感觉非常有价值。