Associations of diabetes self-efficacy, body image, and patient involvement with perceived person-centered critical care among patients undergoing diabetes-related lower limb amputation

Diabetes-related lower limb amputation (LLA) poses significant physical and psychosocial challenges, impacting self-efficacy, body image, and patient engagement in care. While previous research has largely focused on healthcare providers’ perspectives or patients’ general attitudes, there is limited understanding of how diabetic self-efficacy, body image, and patient perception of involvement in care interact to influence person-centered care perception. This study aimed to explore the relationships among diabetic self-efficacy (DSE), amputee body image (ABI), and patient perception of involvement in care (PPIC), and their potential pathways toward enhancing person-centered critical care perception (PCCP) among patients with diabetes undergoing LLA. A cross-sectional, correlational design was used with a convenience sample of 200 patients recruited from the Vascular Surgery Department and the Diabetes rehabilitation Center at the Main Assiut University Hospital, and its outpatient clinics. Data were collected using the Patient version of the Person-Centered Critical Care Nursing Questionnaire (PCCNPq), the Arabic Diabetes Self-Efficacy Scale (A-DSES), the Perceived Involvement in Care Scale (PICS), and the Amputee Body Image Scale (ABIS). Statistical analyses included descriptive statistics, correlation analysis, and path analysis to examine direct and indirect relationships among study variables. Patients reported low diabetic self-efficacy (83.0%), poor involvement in care (97.0%), and poor person-centered care perception (64.0%), while body image disturbance was prevalent. Diabetic self-efficacy was positively correlated with patient perception of involvement in care ( r = .502, p < .001) and negatively correlated with body image disturbance ( r = − .227, p = .001). Patient perception of involvement in care was also negatively associated with body image disturbance ( r = − .202, p = .004). However, no significant associations were found between DSE, PPIC, or ABI and perceived person-centered care. Path analysis confirmed these findings, with no significant direct effects on PCCP. Diabetic self-efficacy is associated with greater patient involvement in care and lower body image disturbance among patients with diabetes-related amputation. However, these variables were not significantly associated with perceptions of person-centered care in this study. The hypothesized pathways linking these factors to person-centered care should therefore be considered exploratory. Interventions targeting self-efficacy and patient engagement may improve psychosocial outcomes, but further longitudinal research is needed to clarify their role in shaping perceptions of person-centered care.