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The purpose of this study was to develop a reliable and valid instrument to identify problem areas in the use of prostheses by lower extremity amputees. Maslow's Hierarchy of Needs and Roy's Adaptation Model provided the conceptual framework. Forty-six items defining four dimensions were conceptualized as manifesting the interactive process between needs fulfillment and adaptation—activities of daily living, social participation, sexual activity, and athletic participation. Procedures used in the development of the instrument and described in this article provided considerable support for its reliability and validity.