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OBJECTIVE: This study aimed to investigate the relationship between fatalism, death anxiety, and compliance with type 2 diabetes mellitus (T2DM) treatment in patients who had undergone limb amputation due to diabetic complications. METHODS: A mixed-method design was used, combining quantitative and qualitative data. The sample consisted of 93 patients with diabetes who had undergone amputation and who completed surveys, and 20 who participated in in-depth interviews. Qualitative data were analyzed using a phenomenological approach. Scales included the Fatalism Scale, Thorson-Powell Death Anxiety Scale, and the T2DM Treatment Compliance Scale. RESULTS: Significant differences were observed across education levels in death anxiety, treatment compliance, and fatalism (P<.05). The quantitative analysis revealed a significant positive effect of fatalism on treatment compliance (β=0.427, P<.001). Because higher scores on this scale indicate lower adherence, this result suggests that higher fatalism is associated with reduced treatment compliance. Death anxiety did not have a statistically significant direct effect on treatment compliance (β=-0.177, P=.072). Qualitative findings supported these results and identified 3 main concepts: challenges in adapting to amputation, managing diabetes treatment, and psychological and belief-based challenges. Three themes were identified: issues with adapting to the condition, treatment adherence, and fatalism, death anxiety, and psychological effects. CONCLUSIONS: Fatalism plays a crucial role in treatment compliance for diabetic foot and amputation-related DM, whereas the impact of death anxiety is less direct. To improve compliance, addressing fatalistic beliefs and providing psychological support is essential. Tailored interventions, including psychological counseling and patient-specific educational programs, could significantly enhance adherence in amputated diabetic patients.
Sengul et al. (Thu,) studied this question.