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ABSTRACT
Little research has been done on the experience of diabetes-related amputation. The aim of this study was to allow amputees to describe their experiences of amputation and to generate grounded theory that will lead health professionals towards a more comprehensive understanding of the realities of post-amputation life. Unstructured interviews were conducted with five participants with a diabetes-related amputation living in a rural setting, and their respective carers. The interviews were analysed using Grounded Theory methods. Data analysis revealed three categories: 'imposed powerlessness', 'adaptive functionality' and 'endurance'. The impact of participant's amputations were influenced by continuing limb problems post-amputation and co-existing complications affecting their physical function. Medical errors and lack of awareness of the risks for diabetic amputations resulted in uncertainty and fear. The participants' sense of grief, loss and shock post operatively continued later as they came to terms with their awkwardness of movement, yet they moved forward developing their own sense of hope through a coping process that revealed remarkable ability to endure and exert control over lives that seemed to be at the whim of an ongoing disease process. The substantive theory resulting from this grounded theory study was conceptualised as 'A Path of Perpetual Resilience'. It is important that psychosocial and not just physical adjustment is considered an indicator for determining outcomes for these people, and that future care involves strategies to promote this. A greater sample size is required to determine if these findings are transferable to the general diabetes-related amputation population.
Keywords: diabetes; nursing; amputation; lived experience; grounded theory
Diabetes is a common chronic condition that incurs enormous personal and public health burdens. Foot problems related to diabetes result in significant social, medical and economic consequences and constitute the most common reason for hospital admissions for people with diabetes (Colagiuri, Colagiuri, Conway, Graiger, & Davey, 2003). Foot-related diabetes complications can lead to further functional problems such as amputations of the lower extremities. Almost 5% of persons with diabetes undergo an amputation (Colagiuri et al., 2003). Individuals who have had an amputation face physical, emotional and social consequences that can impact on their psychosocial well-being.
Several studies have examined the area of psychosocial coping following amputation. Thompson and Haran (1984) found that participants who had undergone an amputation experienced...