What is the Impact of Below Ankle Amputation upon Quality of Life for Individuals with Type 2 Diabetes Mellitus?

Student thesis: Doctoral Thesis


The research question arose out of researcher observation of differing practices and patient experiences whilst employed concurrently in two NHS Trusts. The research sought to gain understanding of the impact of diabetes-related below ankle amputation upon quality of life.

Twenty-eight semi-structured individual interviews were undertaken which explored the lived experiences of people who had a below ankle amputation and had been cared for by the same multidisciplinary foot care team. Interviews were analysed using template analysis, a form of thematic analysis which allowed for incorporation of a priori knowledge to contribute to the development of codes and themes. NVivo software was used to assist with the organisation of these findings.

The original contribution to knowledge was identified following data analysis. The analysis revealed a variety of perspectives as to the impact of below ankle amputation upon quality of life. This related to an individual’s acceptance and adaptation to the amputation, regardless of the level of the amputation experienced. Adaptation, and therefore quality of life was impacted by lack of social support, and by difficulties gaining societal support such as social care and monetary support. A conceptual framework was developed to provide a precis of the new knowledge developed. The conceptual framework presented the interaction of factors impacting upon adaptation and factors subjectively perceived as important to quality of life.

The research developed a suggested set of action points for clinicians working with these individuals, such as providing education upon the amputation journey and rehabilitation, establishing levels of support prior to amputation occurring to identify individuals who may require additional psychological or educational support. Further research was suggested to explore the development of measures which combined adaptation and quality of life to understand the impact of below ankle amputation more clearly for the individual. The author also suggested that the person completing the measure should be able to rank and add factors personally important for it to truly gain insight into individual quality of life.
Date of Award23 Sep 2023
Original languageEnglish
SupervisorWarren Gillibrand (Main Supervisor) & Susanna Kola-Palmer (Co-Supervisor)

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