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      Psychosocial adjustment to diabetes-related lower limb amputation.

      Diabetic Medicine
      Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Amputation, psychology, Amputees, Anxiety, Artificial Limbs, Body Image, Depressive Disorder, Diabetes Complications, complications, Female, Humans, Lower Extremity, surgery, Male, Middle Aged, Questionnaires, Social Adjustment

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          Abstract

          To examine psychosocial adjustment in persons with lower limb amputations related to diabetes. Thirty-eight participants with diabetes-related lower limb amputations, recruited from two limb-fitting centres, completed three psychological self-report assessments: the Trinity Amputation and Prosthesis Experience Scales (TAPES); the Hospital Anxiety and Depression Scale (HADS); and the Amputation Body Image Scale-Revised (ABIS-R). Over 18% of participants scored above the normal range (> 8) for depression on the HADS and 18.5% scored above the normal range for anxiety. Both depression (rho = 0.75, P < 0.01) and anxiety (rho = 0.62, P < 0.01) scores were significantly associated with body image disturbance, as measured using the ABIS-R. Significant relationships were also observed between body image disturbance and three TAPES subscales measuring psychosocial adjustment [general adjustment (rho = -0.48, P < 0.01), social adjustment (rho = -0.51, P < 0.01), adjustment to limitations (rho = -0.45, P < 0.05)]. Individuals with diabetes-related amputations may be at elevated risk for psychological distress as a result of their co-morbid medical condition. Regular screening for anxiety and depression and the provision of appropriate follow-up care may therefore be advisable in this population.

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