University of South Australia Allied Health and Human Performance, University of South Australia, Adelaide, SA, 5000, Australia.
Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
J Foot Ankle Res. 2022 Dec 12;15(1):89. doi: 10.1186/s13047-022-00589-6.
Lower extremity amputations (LEAs) as a result of type 2 diabetes mellitus (T2DM) cause considerable morbidity, mortality, and burden on the healthcare system. LEAs are thought to be preventable, yet the rate of LEAs, particularly in Australia, has risen despite the availability of preventative healthcare services. Understanding patient's perspectives of risk factors for LEAs may provide valuable insight into why many LEAs occur each year.
The aim of this study was to explore patient's perspectives of risk factors for LEAs as a result of T2DM.
A qualitative descriptive methodology involving non-probability purposive sampling was used to recruit inpatients at a tertiary metropolitan hospital in South Australia. Semi-structured interviews were conducted, and data were transcribed verbatim. Data from the interviews were analysed using thematic analysis and the constant comparison approach.
A total of 15 participants shared their perspectives of risk factors for lower extremity amputations. Most (86%) of participants were male and Caucasian, with a median age of 66.4 years ranging from 44-80 years. The median duration of diabetes was 25.2 years, ranging from 12-40 years. More than half of the participants had undergone a previous amputation with 86% being unemployed or retired and 73% living in metropolitan Adelaide. Two main themes emerged: competing priorities and awareness. Finance and family care were identified as subthemes within competing priorities. While subthemes in the context of awareness related to lack of awareness of risk, experiences with health care professionals and perspectives of disease severity.
The findings from this research indicate that addressing risk factors for LEAs for patients with T2DM require a holistic and nuanced approach which considers individual patient's circumstances, and its influence on how risks are viewed and managed.
由 2 型糖尿病（T2DM）引起的下肢截肢（LEAs）会导致相当大的发病率、死亡率和医疗系统负担。LEAs 被认为是可以预防的，但尽管有预防保健服务，LEAs 的发生率，特别是在澳大利亚，仍在上升。了解患者对 T2DM 导致 LEAs 的风险因素的看法，可能有助于深入了解为什么每年都会发生许多 LEAs。
本研究旨在探讨患者对 T2DM 导致 LEAs 的风险因素的看法。
采用非概率目的抽样的定性描述方法，在南澳大利亚州一家三级大都市医院招募住院患者。进行半结构化访谈，并逐字转录数据。使用主题分析和恒比法对访谈数据进行分析。
共有 15 名参与者分享了他们对 T2DM 导致下肢截肢风险因素的看法。大多数（86%）参与者为男性和白种人，年龄中位数为 66.4 岁，范围为 44-80 岁。糖尿病的中位病程为 25.2 年，范围为 12-40 年。超过一半的参与者曾接受过截肢手术，86%的人失业或退休，73%的人居住在阿德莱德大都市区。出现了两个主要主题：竞争优先级和意识。财务和家庭护理被确定为竞争优先级的子主题。而在意识方面的子主题与对风险缺乏意识、与医疗保健专业人员的经历和对疾病严重程度的看法有关。
这项研究的结果表明，为 T2DM 患者解决 LEAs 的风险因素需要采取整体和细致入微的方法，考虑到患者的个人情况及其对风险的看法和管理的影响。
