Acceptance of illness, quality of life and nutritional status of patients after lower limb amputation due to diabetes mellitus

Ann Vasc Surg. 2022 Feb:79:208-215. doi: 10.1016/j.avsg.2021.07.023. Epub 2021 Oct 10.

Abstract

Introduction: Diabetes mellitus is one of the most common chronic diseases with a high number of sufferers worldwide. Diabetic neuropathy and diabetic angiopathy lead to serious infectious complications which are very difficult to combat and may finally lead to the amputation of a lower limb. The aim of the study was to evaluate the quality of life, the level of acceptance of the illness and the nutritional status of patients after lower limb amputation due to diabetes.

Methods: Ninety-nine patients (23 men and 76 women) were enrolled into the study. They had all undergone lower limb amputation due to diabetic foot and were treated in the Department of General and Oncological Surgery. The following questionnaires were used: the WHO Quality of Life-BREF (WHOQOL-BREF), the Mini Nutritional Assessment (MNA), the Acceptance of Illness Scale (AIS) and the anonymous specific socio-demographic characteristics questionnaire.

Results: The diabetes-related amputees were revealed to have a higher QoL within the social domain (mean score 64.48), an intermediate QoL - within the environmental domain (mean score 63.04) and the mental domain (mean score 59.61), and a lower QoL - within physical (somatic) domain (mean score 54.69). There was no statistical correlation between genders or between all the domains of QoL (P > 0.05). The mean MNA score was 22.66, which means that patients were at risk of malnutrition. There were statistical differences between women and men as regards nutritional status (P = 0.034). The mean AIS score was 27.65 (27.09 women and 29.48 men), which means that the respondents accept their disease. There was no statistical correlation between gender and the acceptance of the disease (P = 0.288). There was not statistical correlation between age and QoL (P > 0.05). There were statistical differences between age and nutritional status (P < 0.05), and between age and acceptance of the illness (P = 0.044).

Conclusions: The better the quality of life was in all the domains, the better the level of acceptance of illness was. The less malnourished the patient was, the better their quality of life was in all the domains.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical* / adverse effects
  • Amputees / psychology*
  • Diabetic Foot / diagnosis
  • Diabetic Foot / physiopathology
  • Diabetic Foot / psychology
  • Diabetic Foot / surgery*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Illness Behavior*
  • Lower Extremity / blood supply*
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / physiopathology*
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status*
  • Predictive Value of Tests
  • Quality of Life*
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome