Resilience in Patients with Diabetes-Related Lower Limb Amputation
Gábor Makai1, *, Edina Rátvai1, Judit Veszely1, Barbara Pethes2, Enikő Csilla Kiss3
1 Department of Rehabilitation, Medical Centre, Hungarian Defence Forces, Budapest, Hungary
2 Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
3 Institute of Psychology, University of Pecs, Pécs, Hungary
Several factors may hinder postoperative rehabilitation following lower limb amputation. This study contributes to the existing knowledge of the impact of psychological factors on patients’ successful adaptation.
The study focused on the importance of resilience following lower limb amputation due to diabetes mellitus, especially on protective and risk factors potentially influencing adaptation to limb loss.
Patients (n=29) completed a test battery one and sixth months after amputation including the following questionnaires: Beck Depression Inventory (BDI-R), Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), Medical Outcomes Study Social Support Survey (MOS-SSS), Sense of Coherence Scale (SOC), Positive and Negative Affect Schedule (PANAS).
Anxiety, depression and negative emotional states negatively correlated with resilience, suggesting to be risk factors hindering adaptation. Positive effects act as a protective factor, while negative emotions hinder coping with the trauma, particularly six months after limb loss. The overall score and all three subscales of the MOS-SSS correlated positively with resilience at both measurements, which suggests that social support has importance in successfully dealing with resilience. Patients’ Sense Of Coherence (SOC) was found to be positively correlated with resilience six months after amputation suggesting it is also a protective factor.
This study expands the limited empirical knowledge of patients with lower limb amputation due to diabetes mellitus. The study approached adaptation to limb loss from a new perspective focusing on protective and risk factors related to resilience. A complex test battery was compiled to implement the new approach to the essential protective factors in rehabilitation.
Keywords: Resilience, Diabetes-related lower limb amputation, Rehabilitation, Distress and depression, Protective and risk factors, SOC.
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* Address correspondence to this author at the Gábor Makai, Department of Rehabilitation, Medical Centre, Hungarian Defence Forces, 2/A. Szanatórium street, 1121, Budapest, Hungary; Tel: +3620 536 0182;