The psychosocial impact associated with diabetes‐related amputation

McDonald, Sarah; Sharpe, Louise; Blaszczynski, Alex

doi:10.1111/dme.12474

Cited by 28 publications

(24 citation statements)

References 25 publications

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“…The similar and comparable domains, vitality (SF‐36) and energy (NHP), also presented inferior scores for patients with chronic wounds . For emotional‐ and mental health domains, four studies reported lower HRQoL scores for patients with chronic wounds, while five studies did not find any statistical difference when compared to controls . Four studies with control groups reported significantly lower scores for patients with chronic wounds in the domains of bodily pain and pain/discomfort .…”

Section: Resultsmentioning

confidence: 93%

The humanistic and economic burden of chronic wounds: A systematic review

Olsson

Järbrink

Divakar

et al. 2018

Wound Repair Regeneration

525

392

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Chronic wounds are a health problem that have devastating consequences for patients and contribute major costs to healthcare systems and societies. To understand the magnitude of this health issue, a systematic review was undertaken. Searches were conducted in MEDLINE, EMBASE, EBM Reviews and Cochrane library, CINAHL, EBSCO, PsycINFO, and Global Health databases for articles published between 2000 and 2015. Included publications had to target adults (≥18 years of age), state wound chronicity (≥3 weeks) and/or label the wounds as chronic, complex, hard‐to‐heal, or having led to an amputation. The review excluded studies that did not present data on generic health‐related quality of life and/or cost data, case studies, randomized controlled trials, economic modeling studies, abstracts, and editorials. Extracted data were summarized into a narrative synthesis, and for a few articles using the same health‐related quality of life instrument, average estimates with 95% confidence intervals were calculated. Thirty articles met the inclusion criteria. Findings revealed that health‐related quality of life was lowest for physical pathologies, and based on average estimates were scores most inferior in the domain physical role for both patients with chronic wounds and for those with wound‐related amputations. The cost burden was mainly attributed to amputations for patients also comorbid with diabetes, where the cost for hospitalization ranged from US$12,851 to US$16,267 (median) for this patient group. Patients with chronic wounds have poor health‐related quality of life in general and wound‐related costs are substantial. Development and implementation of wound management strategies that focus on increasing health‐related quality of life and effectively reduce costs for this patient group are urgently needed.

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Section: Resultsmentioning

confidence: 93%

The humanistic and economic burden of chronic wounds: A systematic review

Olsson

Järbrink

Divakar

et al. 2018

Wound Repair Regeneration

525

392

View full text Add to dashboard Cite

show abstract

“…Many studies have explored body image disturbance (Senra et al, 2012;Norlyk et al, 2013;McDonald et al, 2014;Norlyk et al, 2016;Khan et al, 2019) and changed self-identify for patients who have undergone major amputations. In the present study, we found that body image and anxiety was a concern for the participants with both major and minor amputation.…”

Section: Social Awareness and Support To Regain Normalitymentioning

confidence: 99%

Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Zhu

Goh

Chew

et al. 2020

Prim Health Care Res Dev

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Aim: To explore the experiences of patients living with diabetic lower extremity amputation (DLEA) and its post-amputation wound in primary care. Background: DLEA, including both minor and major amputation, is a life-altering condition that brings numerous challenges to an individual’s life. Post-amputation physical wound healing is complicated and challenging because of wound dehiscence and prolonged healing times. Understanding patients’ experiences after DLEA with a post-amputation wound will enable healthcare professionals to develop interventions to assist patients in physical healing and psychosocial recovery. Methods: This study employs a qualitative design using interpretative phenomenological analysis (IPA). A purposive maximum variation sample of nine patients who had had lower extremity amputations and post-amputation wound attributed to diabetes in the previous 12 months was recruited from a primary care setting in Singapore. Semi-structured audio recorded one-to-one interviews with a duration of 45–60 min each were conducted between September 2018 and January 2019. The interviews were transcribed verbatim and analysed using IPA. Findings: The essential meaning of the phenomenon ‘the lived experiences for patients with DLEA and post-amputated wound’ can be interpreted as ‘struggling for “normality”’ which encompasses four domains of sense making: physical loss disrupted normality, emotional impact aggravated the disrupted normality, social challenges further provoked the disrupted normality, and attempt to regain normality. The study highlights the complex physical and psychosocial transition facing patients after DLEA before post-amputation wound closure. In primary care, an amputation, whether minor or major, is a life-altering experience that requires physical healing, emotional recovery, and social adaptation to regain normality. Patients living with DLEA and a post-amputation wound may benefit from an interdisciplinary team care model to assist them with physical and psychosocial adjustment and resume normality.

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“…Possibly due to its complications [ 3 , 4 ] and also its effects on activities of daily living and well-being and social life [ 5 – 9 ], individuals with diabetes are at higher risk of depression [ 10 , 11 ]. The prevalence rate of depression is three-times higher in people with type 1 diabetes and nearly twice as high in people with type 2 diabetes compared to controls [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Association between number of comorbid medical conditions and depression among individuals with diabetes; race and ethnic variations

Lankarani

Assari

2015

J Diabetes Metab Disord

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BackgroundMedical and psychiatric comorbidities are commonly comorbid with diabetes. Race and ethnicity may, however, modify the link between medical and psychiatric comorbidities in individuals with diabetes. In this study we compared Non-Hispanic Whites, African Americans, and Caribbean Blacks with diabetes for the association between number of comorbid medical conditions and lifetime and 12-month major depressive disorder (MDD) in individuals with diabetes.MethodsData came from the National Survey of American Life (NSAL), 2001–2003. We included 603 patients with diabetes (75 non-Hispanic Whites, 396 African Americans, and 131 Caribbean Blacks). Number of comorbid medical conditions was the independent variable, lifetime and 12-month MDD were dependent variables, and age, gender, education, marital status, employment, and body mass index were covariates. Race- and ethnic- specific logistic regressions were used to determine race and ethnic differences in the associations between number of chronic medical conditions and lifetime and 12-month MDD, while the effect of all covariates were controlled.ResultsNumber of chronic medical conditions was positively associated with lifetime MDD among non-Hispanic Whites (OR = 1.719, 95 % CI = 1.018 – 2.902) and African Americans (OR = 1.235, 95 % CI = 1.056– 1.445) but not Caribbean Blacks (P > .05). Number of chronic medical conditions was also associated with 12-month MDD among non-Hispanic Whites (OR = 1.757, 95 % CI = 1.119 – 2.759) and African Americans (OR = 1.381, 95 % CI = 1.175 - 1.623) but not Caribbean Blacks (P > .05).ConclusionsThis study shows race- and ethnic- differences in the association between number of medical comorbidities and MDD among patients with diabetes. These findings invite researchers to study the mechanisms behind race- and ethnic- differences in vulnerability and resilience to the mental health effects of chronic medical conditions.

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The psychosocial impact associated with diabetes‐related amputation

Cited by 28 publications

References 25 publications

The humanistic and economic burden of chronic wounds: A systematic review

The humanistic and economic burden of chronic wounds: A systematic review

Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Association between number of comorbid medical conditions and depression among individuals with diabetes; race and ethnic variations

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