Caritas Institute of Higher Education, School of Health Sciences, Tseung Kwan O, Hong Kong, China.
Hong Kong Metropolitan University, Li Ka Shing School of Professional and Continuing Education, Hong Kong, China.
Int Wound J. 2023 Aug;20(6):2159-2168. doi: 10.1111/iwj.14094. Epub 2023 Jan 30.
Despite lower-limb amputation being common among patients with diabetic foot ulcers, few studies have qualitatively investigated the patients' perspectives. Therefore, this study aimed to explore the thoughts and experiences of patients with diabetic foot ulcers regarding lower-limb amputation in Hong Kong. A phenomenological study using individual, semi-structured interviews was conducted with 18 participants with foot ulcers recruited in Hong Kong between July and September 2022. The interviews were audio-recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach and a constant comparison strategy. The results highlighted four substantial themes: (a) coping or being alone and taciturn, (b) altered appearance impacting one's sense of maintaining social relations, (c) thoughts about self-efficacy and encountering a new normal, and (d) the possibility of a reduced gap in physical consequences between the old and new self. This study provided different perspectives of patients with a history of diabetic foot ulcers, even in cases where lower-limb amputation has not yet been performed. The results demonstrate that lower-limb amputation is considered a forbidden topic. This makes it culturally difficult for Chinese patients to discuss the matter with healthcare authorities and family members. Healthcare workers should be aware of how they communicate regarding lower-limb amputation.
尽管下肢截肢在糖尿病足溃疡患者中很常见，但很少有研究从定性角度调查患者的观点。因此，本研究旨在探讨香港糖尿病足溃疡患者对下肢截肢的想法和感受。 2022 年 7 月至 9 月期间，在香港通过个体半结构化访谈对 18 名足部溃疡患者进行了一项现象学研究。对访谈进行了录音、逐字转录，并使用解释性现象学方法和恒定比较策略进行了分析。研究结果突出了四个实质性主题：（a）应对或独自沉默，（b）改变的外观影响维持社会关系的感觉，（c）关于自我效能和遇到新的常态的想法，以及（d）新旧自我之间身体后果差距缩小的可能性。本研究从有糖尿病足溃疡病史的患者的不同角度提供了观点，即使在尚未进行下肢截肢的情况下也是如此。研究结果表明，下肢截肢被认为是一个禁忌话题。这使得中国患者在与医疗保健当局和家庭成员讨论此事时在文化上存在困难。医疗保健工作者应该意识到他们在谈论下肢截肢时的沟通方式。
