Quality of life after lower extremity amputation due to diabetic foot ulcer: The role of prosthesis-related factors, body image, self-esteem, and coping styles

Abstract

Objective: The purpose of this study was to identify clinical and psychosocial factors that predict an individual's subjective quality of life after having undergone a lower limb amputation secondary to diabetic foot ulcer. Method: The study sample comprised 65 patients who underwent amputation because of an infected diabetic foot ulcer. Short Form 36, The Trinity Amputation and Prosthesis Experience Scale, Coping Attitudes Evaluation Scale, Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, and Amputee Body Image Scale were administered as questionnaires. Stepwise linear regression analysis was conducted to assess the factors predicting quality of life. Results: Quality of life was negatively correlated with depression, anxiety, body image, activity limitation, and dysfunctional coping strategies and positively correlated with perceived social support, satisfaction with prosthesis, self-esteem, and problem-focused coping style. Regression analysis showed satisfaction with prosthesis and body perception, problem-focused coping strategies, dysfunctional coping strategies, and self-esteem to be the factors with the highest predictive power for the physical component of quality of life, while body perception, problem-focused, and dysfunctional coping strategies were the strongest predictors for the mental component of quality of life. Conclusion: Impaired body image and self-esteem, less usage of problem-focused and high usage of dysfunctional coping strategies, in addition to low satisfaction with the prosthesis were the strongest predictors for poor quality of life. Factors associated with better quality of life after the amputation were investigated in this study, which may support future development of post-amputation rehabilitation strategies for lower limb amputees.