Juzwiszyn Jan, Łabuń Adrianna, Tański Wojciech, Szymańska-Chabowska Anna, Zielińska Dorota, Chabowski Mariusz
Division of Nervous System Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Department of Internal Medicine, 4(th) Military Teaching Hospital, Wrocław, Poland.
Ann Vasc Surg. 2022 Feb;79:208-215. doi: 10.1016/j.avsg.2021.07.023. Epub 2021 Oct 10.
Diabetes mellitus is one of the most common chronic diseases with a high number of sufferers worldwide. Diabetic neuropathy and diabetic angiopathy lead to serious infectious complications which are very difficult to combat and may finally lead to the amputation of a lower limb. The aim of the study was to evaluate the quality of life, the level of acceptance of the illness and the nutritional status of patients after lower limb amputation due to diabetes.
Ninety-nine patients (23 men and 76 women) were enrolled into the study. They had all undergone lower limb amputation due to diabetic foot and were treated in the Department of General and Oncological Surgery. The following questionnaires were used: the WHO Quality of Life-BREF (WHOQOL-BREF), the Mini Nutritional Assessment (MNA), the Acceptance of Illness Scale (AIS) and the anonymous specific socio-demographic characteristics questionnaire.
The diabetes-related amputees were revealed to have a higher QoL within the social domain (mean score 64.48), an intermediate QoL - within the environmental domain (mean score 63.04) and the mental domain (mean score 59.61), and a lower QoL - within physical (somatic) domain (mean score 54.69). There was no statistical correlation between genders or between all the domains of QoL (P > 0.05). The mean MNA score was 22.66, which means that patients were at risk of malnutrition. There were statistical differences between women and men as regards nutritional status (P = 0.034). The mean AIS score was 27.65 (27.09 women and 29.48 men), which means that the respondents accept their disease. There was no statistical correlation between gender and the acceptance of the disease (P = 0.288). There was not statistical correlation between age and QoL (P > 0.05). There were statistical differences between age and nutritional status (P < 0.05), and between age and acceptance of the illness (P = 0.044).
The better the quality of life was in all the domains, the better the level of acceptance of illness was. The less malnourished the patient was, the better their quality of life was in all the domains.
糖尿病是全球患病人数众多的最常见慢性病之一。糖尿病神经病变和糖尿病血管病变会引发严重的感染并发症，这些并发症极难应对，最终可能导致下肢截肢。本研究的目的是评估因糖尿病导致下肢截肢患者的生活质量、疾病接受程度和营养状况。
99名患者（23名男性和76名女性）纳入本研究。他们均因糖尿病足接受了下肢截肢手术，并在普通外科和肿瘤外科接受治疗。使用了以下问卷：世界卫生组织生活质量简表（WHOQOL - BREF）、微型营养评定法（MNA）、疾病接受量表（AIS）以及匿名的特定社会人口学特征问卷。
糖尿病相关截肢患者在社会领域的生活质量较高（平均得分64.48），在环境领域（平均得分63.04）和心理领域（平均得分59.61）的生活质量中等，而在身体（躯体）领域的生活质量较低（平均得分54.69）。性别之间或生活质量的所有领域之间均无统计学相关性（P>0.05）。MNA平均得分为22.66，这意味着患者存在营养不良风险。男女在营养状况方面存在统计学差异（P = 0.034）。AIS平均得分为27.65（女性为27.09，男性为29.48），这意味着受访者接受自己的疾病。性别与疾病接受程度之间无统计学相关性（P = 0.288）。年龄与生活质量之间无统计学相关性（P>0.05）。年龄与营养状况之间存在统计学差异（P<0.05），年龄与疾病接受程度之间也存在统计学差异（P = 0.044）。
所有领域的生活质量越好，疾病接受程度越高。患者营养不良程度越低，其在所有领域的生活质量越好。
