Abdelgadir Moawia, Shebeika Wafaa, Eltom Mohamed, Berne Christian, Wikblad Karin
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
Tohoku J Exp Med. 2009 Jan;217(1):45-50. doi: 10.1620/tjem.217.45.
Quality of life is an important outcome measure in diabetic patients with lower limb amputation (LLA). The aim of this study was to investigate the influence of lower limb amputation on health-related quality of life (HRQOL) in Sudanese diabetic subjects. Additionally the Sense of Coherence scale (SOC-13) and a symptom check list was used in subjects with LLA. A total of 60 (M/F; 40/20) diabetic subjects with LLA and 60 (M/F; 23/37) diabetic reference subjects without LLA, were studied. For both groups HRQOL was measured using The Medical Outcomes Study questionnaire (MOS). Subjects with LLA had significantly poorer HRQOL compared to the reference group in most HRQOL domains (p < 0.0001). Duration of diabetes had the greatest negative impact on HRQOL in both groups, those with LLA (p < 0.0001), and in those without LLA (p < 0.0001), although subjects who were amputated earlier had poorer HRQOL than recently amputated (p < 0.0001). Higher SOC scores were recorded in LLA patients who have greater ratings of positive feelings, family satisfaction and sleep in the HRQOL examination (p < 0.0001). In conclusion, Sudanese diabetic subjects with LLA have a poor quality of life. The triad of diabetes duration, symptoms and amputations, has turned to be important risk factor for poorer HRQOL. Functional and mobility status were suggested to be an important determinant of HRQOL among this population. As the Sudanese population has coherent social relationships, this poor performance of the diabetic subjects will certainly increase the burden on the whole family, in both integrity and economical status. Nevertheless, these deep-rooted social interrelations together with increasing diabetes awareness have substantially improved the family satisfaction among our patients.
生活质量是下肢截肢（LLA）糖尿病患者的一项重要结局指标。本研究旨在调查下肢截肢对苏丹糖尿病患者健康相关生活质量（HRQOL）的影响。此外，还对LLA患者使用了连贯感量表（SOC - 13）和症状检查表。共研究了60名（男/女；40/20）患有LLA的糖尿病患者和60名（男/女；23/37）无LLA的糖尿病对照患者。两组均使用医疗结局研究问卷（MOS）测量HRQOL。在大多数HRQOL领域，LLA患者的HRQOL明显低于对照组（p < 0.0001）。糖尿病病程对两组的HRQOL均有最大的负面影响，LLA患者（p < 0.0001）和无LLA患者（p < 0.0001）均如此，不过早期截肢患者的HRQOL比近期截肢患者更差（p < 0.0001）。在HRQOL检查中，积极情绪、家庭满意度和睡眠评分较高的LLA患者的SOC得分更高（p < 0.0001）。总之，苏丹患有LLA的糖尿病患者生活质量较差。糖尿病病程、症状和截肢这三者已成为HRQOL较差的重要危险因素。功能和活动状态被认为是该人群HRQOL的重要决定因素。由于苏丹人群有紧密的社会关系，糖尿病患者的这种不佳状况肯定会在家庭完整性和经济状况方面给整个家庭增加负担。尽管如此，这些根深蒂固的社会关系以及糖尿病意识的提高已显著改善了我们患者的家庭满意度。
