الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 176 |  |  |
| | | from | 176 | | |
Abstract
Amputation is often an inevitable procedure in the advanced condition of various diseases, including diabetes mellitus, and pass a dramatic impact on a patient’s life of physical, psychological, social and financial affecting (Greetzen,2014).
Amputation of a limb confronts the individual with a multitude of involving physical and psychosocial challenges such as impairments in physical functioning, prosthesis use, pain, changes in employment status or occupation, as well as alterations in body image and self-concept( Schmitt et al., 2012). Amputation produces a significant impact on the psychological and social aspects of the affected patients (Atherton & Robertson, 2012).
Aim of the study:
The aim of this study was to assess lifestyle of diabetes patients post amputation through:-
1. Identifying health needs & problems associated with amputation.
2. Assessing patient‘s lifestyle throughout amputation.
Research Questions:
3. What are health needs and problems of patients post amputation?
4. What is the effect of amputation on the physical, social, psychological &spiritual health of patients?
5. Is there relation between lifestyle and type of amputation?
Research setting:-
This study was conducted at surgical outpatient clinics (general, plastic and vascular), affiliated to Ain Shams university specialized hospital.
Sampling :
The type of study sample was purposive sampled. The final samples included in this study were 100 diabetic patients post amputation .
Tools of date collection:-
The data were collected through the following tools:
Tool (I) : An interviewing questionnaire It was designed by the researcher in simple Arabic language after reviewing related literature to assess the following parts, it includes:
First part: Socio demographic data such as age, gender, marital status, level of education, occupation and habits regard smoking, nutrition intake , housing condition
Second part: It deals with medical background data for diabetic patients post amputation. That contains the following:
a) Patient past&present history, it includes medical, surgical, and family history of a patient with an amputation.
b) Physical assessment that includes reason, onset, site, level of amputation, wound complication, assistive device, pain and activities of daily living assessment.
Tool (II): it includes data about the needs and problems of diabetic patient post amputation.
Tool (III): Concerning with Factors affecting lifestyle for diabetics , post amputation such as:
Physical factor includes items regarding smoking, pain, discomfort, activities of daily living, etc., social factors as personal relationships, culture, social support, etc, psychological factors including suffering, self-esteem, body image and appearance, satisfaction, etc. and spiritual factors regarding the vision for the futures.
Results:
The results of the present study could be summarized as follows:the main finding of this study revealed that:
An analysis of demographic characteristics studied sample showed that 9% with ages ranged from 40 -50 years , 74% are married &22% widow, or divorced,13% are illiterate, 44% average educations and 43% had completed their university education ,also 58% smoking before amputation& average smokers decreased after amputation 52%.
In relation to health status assessment , 71% of patients had a right side amputation and 41% had left side amputation, 25% had right below knee, 10% had left below knee, 35% had right above knee, 19%had left above knee amputation and less than half of them 43% had first time to visit, and majority of them 91% had made medical examination, 75% had made an examination periodically and 77% regularly take healthy guidance for your condition care post amputation.
An analysis the effect of the amputation on the lifestyle of the patients: the psychological aspect is the most frequently affected aspects by amputation 97%, the physical lifestyle affection is also prevalent among the patient being reported by 78% while the social aspect is affected in 57% of the patients.
Conclusion:
Based on the findings of the present study, the conclusion included that: Diabetic patient’s post amputation in this study found There were highly statically significant relation for physical problem of the patients with bilateral amputation and highly statistical significant for physical need for the patient with right sided, left sided or bilateral amputation.The highest level affected was psychological aspect, and physical aspect is the second most common affected by amputation and there were very highly statical significant lower limb amputation compared to of the patients with upper limb amputation .
Recommendations:
In the light of these findings, it is recommended that:
• Comprehensive nursing management protocol focusing on role of the community health nurse to deal with diabetic patients post amputation to help such patients through the adjustment process.
• Establishment of rehabilitation program for multidisciplinary team, including social worker, community nurse, psychiatric nurse and physiotherapist to support successful community.
• Development of educational program for patient post amputation to enhance their ability to deal with amputation.
• Providing psychological, religious counseling program which emphasizes on spiritual solution to the patient’s problems.
• Assess lifestyle of diabetic patient post amputation during rehabilitation -period.