Previously submitted to: JMIR Mental Health (no longer under consideration since Sep 06, 2023)
Date Submitted: Sep 5, 2023
Open Peer Review Period: Aug 23, 2023 - Sep 6, 2023
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Experiences of middle-aged individuals with lower extremity amputation caused by diabetic foot ulcer in China: A qualitative study
ABSTRACT
Background:
Diabetic foot ulcer (DFU) is a major complication of diabetes and a leading cause of lower extremity amputation (LEA). DFU disproportionately affects non-White populations, residents of densely populated areas, and people living in underdeveloped economies. In China, the amputation rate for individuals with DFU is 19.03%. The number of middle-aged people with DFU is increasing. LEA caused by DFU seriously impacts the physical and mental health of affected individuals, with high infection and re-ulceration rates and increased mortality. Middle-aged individuals with DFU-related LEA face unique challenges due to their important family and social roles. Understanding their experiences is vital in developing effective postoperative care interventions.
Objective:
We aimed to understand the experiences of individuals who undergo LEA due to DFU.
Methods:
Semi-structured interviews were used in this qualitative descriptive study. Eleven middle-aged patients (45–59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analyzed.
Results:
Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self-concept stress, and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over-focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption, and (10) poor participation in medical decision-making.
Conclusions:
This study contributes to a deeper understanding of the multidimensional challenges faced by middle-aged individuals who undergo LEA due to DFU and sheds light on the experiences of patients in managing their roles. Although most study participants were able to adapt to the impact of limb loss on their self-perception, they continued to grapple with adjusting to changes in their physical appearance and coping with the psychological effects of limb loss. Our findings highlight the importance of post-LEA recovery and mental support for patients with DFU-related LEA, offering valuable insight for ongoing rehabilitation and treatment.
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