Effect of lower extremity amputation on caregiving burden in caregivers of patients with diabetic foot: Prospective cohort study

Abstract

Lower extremity amputation as a treatment of diabetic foot ulcer is probably a major burden for the patient's family and friends, who typically act as caregivers and support the patient in coping with the physical disabilities and emotional distress. In the present prospective study, we investigated the effects of different lower extremity amputation levels for diabetic foot ulcer treatment on caregivers of patients with diabetes using the Zarit Burden Interview (ZBI‐12) scale. Patients with diabetic foot ulcers who underwent unilateral major amputation (above‐below knee) and minor amputation of foot (heel sparing) and their caregivers were requested to volunteer to participate in this study from June 2016 to December 2018. The ZBI‐12 form was completed immediately preoperatively and 3 and 6 months after postoperatively. In the minor amputation group, the mean age of the 51 patients was 72.1 years. In the major amputation group, the mean age of the 88 patients was 73.7 years. Both groups of caregivers of patients with minor amputation and major amputations showed a significant improvement in ZBI‐12 score when compared preoperatively and at 3‐ and 6‐month follow‐up visits. The mean ZBI‐12 score was significantly higher in the major than in the minor amputation group in preoperative and all postoperative visits. The absence of the ankle joint in the below‐ or above‐knee amputation renders it more difficult for the amputee to quickly learn the use of prosthesis, thereby increasing the burden of the patient and caregivers. We found that lower extremity amputation for the treatment of chronic diabetic foot ulcers has significantly favourable effect on the caregiver burden, and thereby heel sparing was considerably more effective for the caregiver burden.

Trends of limb amputation considering type, level, sex and age in Saskatchewan, Canada 2006–2019: an in-depth assessment

“…Keywords: Epidemiology, Incidence, Amputation, Lower extremity, Upper extremity Background Limb amputation (LA) is a life-changing procedure that impacts physical function and imposes economic burden on patients, caregivers, and the healthcare system [1][2][3][4][5]. Most epidemiologic reports focus on lower extremity amputation (LEA) caused by dysvascular disease, specifically diabetes mellitus (DM) [6,7].…”

Autologous Adipose-Derived Mesenchymal Stem Cells Embedded in Platelet-Rich Fibrin in Diabetic Foot Ulcers

“…Diabetic foot infections have been an increasingly common problem globally due to the sustained rise in new incidences of diabetes and the increasing body weight of diabetic patients [1] [2]. They usually arise either as a skin ulceration caused by a sensory or motor peripheral neuropathy or as a trauma-induced wound [1].…”

Informal Family Caregiving of Patients with Diabetic Extremity Wounds: An Integrative Review

“…Lower caregiving burden was associated with the availability of other informal help, lower level of amputation, formal employment, and ability to take paid time off (Costa et al, 2018, 2020b). The caregiving burden decreased over time in two studies (Çamur et al, 2020; Costa et al, 2018).…”

“…Elevated caregiver burden was measured in four studies, while elements associated with burden and psychological distress (e.g., stress, anxiety) were noted in all caregiver samples, regardless of specific measures used. Higher caregiver burden scores were associated with lower incomes, lack of employment outside the home, lack of other informal caregivers with whom to share responsibilities, lack of a perceived choice regarding caregiving responsibilities, and caring for patients who underwent above-the-knee amputations as opposed to below-the-knee amputation (Çamur et al, 2020; Costa et al, 2018; Hançerlioğlu et al, 2021). Lower caregiving burden was associated with the availability of other informal help, lower level of amputation, formal employment, and ability to take paid time off (Costa et al, 2018, 2020b).…”