Ratliff Catherine R, Strider David, Rovnyak Virginia
University of Virginia Health System, Charlottesville, VA.
Wound Manag Prev. 2019 Apr;65(4):34-40.
Studies have shown above- or below-the-knee amputation has a profound impact on physical, mental, and emotional health; the impact of having a toe(s) amputated is unknown.
This descriptive research study measured health-related quality of life (HRQoL) using the Vascular Quality-of-Life Questionnaire-6 (VascuQol-6) among persons with peripheral arterial disease (PAD) who had undergone toe amputations.
A list of 127 patients discharged from the hospital in 2016 with a diagnosis of PAD and toe amputation was provided to the investigator. The independent variables of age (subsequently divided into groups of persons <65 and ≥65 years of age), gender, race, diabetes mellitus, and time of PAD diagnosis (within the year or 2 to 7 years before 2016) were abstracted from the patient charts. A letter was mailed to potential participants that explained the study and the VascuQol-6 tool, along with a prepaid envelope to return the completed tool. The VascuQol-6 tool is a valid and reliable instrument for assessing HRQoL that covered the different aspects of quality of life (QoL) affected by PAD. The tool contains six 4-point Likert scale questions about activity, symptoms, pain, emotional status, and social life, resulting in a total score between 6 and 24. Higher values indicate better perceived quality of life. Variables were analyzed using frequencies, percentages, means, and standard deviations, and a standard t test was used to compare interval scale items. Statistical significance was noted when P <.05.
Thirty-eight (38) completed surveys were returned (30% completion rate). The mean total score was 15.5 ± 3.93 (range 7-24), and the mean overall score of the 6 items was 2.66 ± 0.90 (range 1-4). In addition to a low overall QoL score, the data showed QoL was negatively affected in every area assessed, but some participants were strongly affected whereas others were not affected at all. No significant differences in QoL scores were noted concerning age groups, gender, race, the presence of diabetes mellitus, or time since PAD diagnosis.
In this study, patients with PAD and toe amputations had low QoL scores related to their disease. Additional research is needed to better understand HRQoL related to PAD to facilitate education of patients considering toe amputation.
研究表明，膝上或膝下截肢对身体、心理和情绪健康有深远影响；而截趾对健康的影响尚不清楚。
本描述性研究使用血管生活质量问卷-6（VascuQol-6）对接受过截趾手术的外周动脉疾病（PAD）患者的健康相关生活质量（HRQoL）进行了测量。
向研究者提供了一份2016年出院的127例诊断为PAD并接受截趾手术患者的名单。从患者病历中提取年龄（随后分为<65岁和≥65岁两组）、性别、种族、糖尿病以及PAD诊断时间（2016年当年或2016年前2至7年）等自变量。向潜在参与者邮寄了一封信，解释了该研究和VascuQol-6工具，并附上一个预付邮资的信封以便返还填写好的工具。VascuQol-6工具是一种有效且可靠的评估HRQoL的工具，涵盖了受PAD影响的生活质量（QoL）的不同方面。该工具包含六个关于活动、症状、疼痛、情绪状态和社交生活的4级李克特量表问题，总分在6至24分之间。分数越高表明生活质量感知越好。使用频率、百分比、均值和标准差对变量进行分析，并使用标准t检验比较区间量表项目。当P<.05时具有统计学意义。
共收回38份（30%的完成率）完整调查问卷。总平均分是15.5±3.93（范围7 - 24），6个项目的平均总分是2.66±0.90（范围1 - 4）。除了总体QoL得分较低外，数据显示在评估的每个领域QoL均受到负面影响，但一些参与者受影响较大，而另一些参与者则完全未受影响。在年龄组、性别、种族、是否患有糖尿病或PAD诊断后的时间方面，QoL得分未发现显著差异。
在本研究中，患有PAD并接受截趾手术的患者因疾病导致QoL得分较低。需要进一步研究以更好地了解与PAD相关的HRQoL，以便为考虑截趾手术的患者提供教育。
