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A qualitative study of the experience of lower extremity wounds and amputations among people with diabetes in Philadelphia
Author(s) -
Barg Frances K.,
Cronholm Peter F.,
Easley Ebony E.,
Davis Trocon,
Hampton Michelle,
Malay D. Scot,
Donohue Cornelius,
Song Jinsup,
Thom Stephen R.,
Margolis David J.
Publication year - 2017
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12593
Subject(s) - amputation , medicine , diabetic foot , qualitative research , quality of life (healthcare) , foot (prosody) , observational study , diabetic foot ulcer , diabetes mellitus , coding (social sciences) , physical therapy , intensive care medicine , surgery , nursing , social science , linguistics , philosophy , statistics , mathematics , sociology , endocrinology
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open‐ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer ( n = 19) or a lower extremity amputation ( n = 20). Interviews were audio‐recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts. Coded data were summarized and examined for patterns. Participants' description of the relationship between diabetes and their foot ulcer or amputation revealed a limited understanding of the disease process. Disruption and loss of independence was expressed whether the person had a foot ulcer or an amputation. Treatment recommendations for foot ulcers were viewed by most as extremely difficult. Amputation was a feared outcome, but some learned to adapt and, at times felt that the amputation enhanced their quality of life. Clinicians have assumed that a focus on limb salvage is preferred over a major amputation. However, because of the complexity of care requiring frequent healthcare provider visits, the frequency of care failure, the frequency of recurrence, and mortality associated with having had a foot ulcer, it may be more appropriate for clinicians to prioritize quality‐of‐life salvage. Foot ulcer treatment failure may be due to a lack of providers' understanding of the impact of treatment on a patient's life.