Key result
Perioperative distress is linked to lower mental QoL after lower limb amputation, while social support buffers physical recovery.
Why the study?
Lower limb amputation due to diabetic foot ulcer leads to emotional and physical sequelae that negatively impact mental and physical quality of life, but the relationships and mediators are not fully understood.
What factors predict mental and physical quality of life in patients undergoing lower limb amputation for diabetic foot ulcers?
Cohort (n=206)
Yes
What factors predict mental and physical quality of life in patients undergoing lower limb amputation for diabetic foot ulcers?
Identifying early emotional reactions and functionality levels can help predict long-term quality of life and guide psychological interventions for diabetic patients undergoing lower limb amputation.
Answers are grounded in this paper and cite their sources.
May inform psychological screening before diabetic amputation; leaves open whether targeting anxiety or depression improves long-term quality of life.
Objective: Lower limb amputation (LLA) leads to several emotional and physical sequelaes that have a negative impact on individuals` life. The objectives of this study were: 1) to analyze the relationship between emotional reactions (anxiety, depression and traumatic stress symptoms) and functionality level, before and after a LLA due to diabetic foot ulcer, and mental/physical quality of life; and 2) to analyze the mediator role of social support between emotional reactions and mental/physical quality of life. Method: A multicenter, longitudinal study with four time assessments: before the surgery, one month, six months, and ten months after surgery, including 206 individuals hospitalized with diabetic foot ulcer indicated for a LLA. The instruments used were the following: Revised Impact of Event Scale; Barthel Index; Hospital Anxiety and Depression Scale and SF-36. Results: Anxiety symptoms before surgery and depression symptoms one month after surgery contribute to Mental Component Score (MCS) ten months after surgery. The level of functionality before and one month after surgery, traumatic stress symptoms one month after surgery as well as satisfaction with social support six months after surgery contribute to the Physical Component Score (PCS), ten months after surgery. Social support was a mediator between traumatic stress symptoms one month after surgery and PCS ten months after surgery. Conclusion: Identifying risk variables and the extent to which and when they affect mental/physical quality of life, will help to develop appropriate psychological interventions to promote quality of life in this population.
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Pedras et al. (2019) conducted a cohort in Diabetic foot ulcer indicated for lower limb amputation (n=206). Emotional reactions and functionality level before and after lower limb amputation was evaluated on Mental Component Score (MCS) and Physical Component Score (PCS) of quality of life at ten months after surgery. Pre-surgery anxiety and post-surgery depression contributed to mental quality of life at 10 months, while social support mediated traumatic stress and physical quality of life.
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