When a diabetic foot ulcer results in amputation: a qualitative study of the lived experience of 15 patients.

Diabetes is a chronic disease that can lead to complications resulting in diabetic foot ulcers (DFUs), foot infections, osteomyelitis, and amputations. Almost 50,000 amputations performed every year in the United States are due to DFUs. A qualitative analysis using Colaizzi's step-by-step approach to phenomenology was conducted to describe the experiences of 15 patients with diabetes living with a foot amputation. Semi-structured interviews were recorded digitally,transcribed, and analyzed. The analysis included reading transcripts multiple times, identifying noteworthy verbatim statements, then abstracting key words and phrases; similar key words and phrases were grouped into a meaning unit. The researchers rereviewed original transcripts, verbatim statements, and extracted key words and phrases and devised meaning units to identify main themes. Rigor in this study was ensured by developing an audit trail that linked the meaning units and themes back to key words and verbatim statements in the original transcripts and then allowing the participant to ensure accuracy of recounted information. Five major themes emerged from the data regarding patient concern about the ability to be productive members of society (i.e., transitioning from having a nonhealing wound to living as a new amputee)--financial burden, powerlessness, social support, placing blame, and uncertainty in one's continued ability--each having implications for health care providers as well as patients. By considering the experience from the patient perspective, health care professionals may be better prepared to discuss patient concerns with follow-up care and day to-day living, especially in getting help with finances. Additional research is needed to uncover models of care that may help these patients remain productive members of society and reduce the burden of amputation on patient quality of life.