Krzemińska Sylwia, Kostka Anna
Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.
Diabetes Metab Syndr Obes. 2021 Mar 19;14:1295-1303. doi: 10.2147/DMSO.S297887. eCollection 2021.
The aim of the study was to evaluate the relationship between pain and quality of life and illness acceptance, anxiety and depression in a group of patients with complicated diabetic foot syndrome, following lower limb amputation.
The studies were carried out in three stages: 7 days, 6 months and 12 months after surgery in a group of 100 patients after amputation of the lower limb due to complications resulting from type 2 diabetes. The study was performed using standardised instruments: WHOQOL-BREF, the Acceptance of Illness Scale (AIS), the Hospital Anxiety and Depression Scale (HADS), and the Visual Analog Scale (VAS) for pain intensity assessment.
Pain occurred in the examined patients throughout the study. The greatest intensity of pain was observed in the postoperative period and significantly weakened over time. Pain intensity was significantly associated with worse overall QoL perceived (-0.255, p=0.011/-0.283, p=0.005) and QoL scores in the physical and psychological domains at the first and second stage of the study (physical domains -0.257, p=0.011/-0.219, p=0.03 and psychological -0.22, p=0.029/-0.24/0.018). The intensity of pain negatively correlates with the acceptance of the disease in all three stages of the study, the greater the severity of pain, the lower the acceptance of illness (-0.298, p=0.003/-0.326, p=0.001/-0.26, p=0.009). The occurrence of anxiety and depression is highly dependent on the severity of pain, especially at the first and second stage of the study (anxiety 0.203, p=0.045/0.257, p=0.01, depression 0.299, p=0.003/0.253, p=0.012). The stronger the pain, the greater the severity of mood disorders.
Pain and its severity are associated with QoL in the patients with complicated diabetic foot syndrome following lower limb amputation. Disease acceptance was lower in patients experiencing more severe pain at all stages of the study. There is an association of pain with the occurrence of anxiety and depression in amputees, especially 6 months after surgery.
本研究旨在评估一组下肢截肢后患有复杂性糖尿病足综合征的患者的疼痛与生活质量、疾病接受度、焦虑和抑郁之间的关系。
研究分三个阶段进行：对100例因2型糖尿病并发症而进行下肢截肢的患者，在术后7天、6个月和12个月进行研究。研究使用标准化工具：世界卫生组织生活质量简表（WHOQOL - BREF）、疾病接受度量表（AIS）、医院焦虑抑郁量表（HADS）以及用于疼痛强度评估的视觉模拟量表（VAS）。
在整个研究过程中，被检查患者均出现疼痛。术后疼痛强度最大，且随时间显著减弱。疼痛强度与研究第一阶段和第二阶段总体生活质量感知较差（-0.255，p = 0.011 / -0.283，p = 0.005）以及身体和心理领域的生活质量得分显著相关（身体领域 -0.257，p = 0.011 / -0.219，p = 0.03；心理领域 -0.22，p = 0.029 / -0.24，p = 0.018）。在研究的所有三个阶段，疼痛强度与疾病接受度呈负相关，疼痛越严重，疾病接受度越低（-0.298，p = 0.003 / -0.326，p = 0.001 / -0.26，p = 0.009）。焦虑和抑郁的发生高度依赖于疼痛的严重程度，尤其是在研究的第一阶段和第二阶段（焦虑 0.203，p = 0.045 / 0.257，p = 0.01；抑郁 0.299，p = 0.003 / 0.253，p = 0.012）。疼痛越强，情绪障碍越严重。
下肢截肢后患有复杂性糖尿病足综合征的患者，疼痛及其严重程度与生活质量相关。在研究的所有阶段，疼痛更严重的患者疾病接受度较低。截肢患者的疼痛与焦虑和抑郁的发生有关，尤其是在术后6个月。
