Pedras Susana, Carvalho Rui, Pereira M Graça
School of Psychology, University of Minho, Braga, Portugal.
Multidisciplinary Diabetic Foot Clinic, Centro Hospitalar do Porto, Porto, Portugal.
Int J Behav Med. 2016 Dec;23(6):714-721. doi: 10.1007/s12529-016-9567-6.
Diabetic foot ulcer (DFU) including amputation surgery has serious consequences for patients, the family and healthcare services. DFU affects not only the physical health-related quality of life (HRQoL) of patients but also their mental well-being. The aims of this study were to find the predictors of HRQoL after surgery, to analyse differences in HRQoL, before and after surgery, and to explore the moderating role of a first versus previous amputation(s) in the relationship between physical and mental HRQoL, before and after surgery, in patients with DFU.
A longitudinal study comprising 108 Portuguese patients was conducted during the period of hospitalization before the surgery and at a follow-up consultation. Participants completed a socio-demographic questionnaire and the SF-36 to assess HRQoL.
Physical and mental HRQoL before surgery predicted HRQoL after surgery, as well as the number of diabetes complications and having received a re-amputation. Physical HRQoL decreased after surgery, but there were no differences on mental HRQoL. Having a previous amputation was a moderator between physical and mental HRQoL before and after surgery.
The results help to identify the most vulnerable patients at risk of having lower HRQoL after surgery, allowing interventions to be tailored to patients' needs in order to promote their quality of life.
糖尿病足溃疡(DFU),包括截肢手术,会给患者、家庭和医疗服务带来严重后果。DFU不仅影响患者与身体健康相关的生活质量(HRQoL),还影响其心理健康。本研究的目的是找出术后HRQoL的预测因素,分析手术前后HRQoL的差异,并探讨首次截肢与既往截肢在DFU患者手术前后身体和心理HRQoL关系中的调节作用。
在手术前住院期间和随访咨询时,对108名葡萄牙患者进行了一项纵向研究。参与者完成了一份社会人口统计学问卷和SF-36以评估HRQoL。
术前的身体和心理HRQoL可预测术后的HRQoL,以及糖尿病并发症的数量和是否接受过再次截肢。术后身体HRQoL下降,但心理HRQoL没有差异。既往有截肢史是手术前后身体和心理HRQoL之间的一个调节因素。
研究结果有助于识别术后HRQoL较低风险的最脆弱患者,从而根据患者需求制定干预措施,以提高他们的生活质量。