Diabetic Amputations: How to Improve Post-Surgical Outcomes Open Access

Abstract

Diabetic amputations are rising in the United States, most specifically with the younger generation (Caffrey 2018). Post-surgical outcomes of diabetic amputations are poor, with high re-amputation rates (Izumi et al. 2006, 566), and high rates of psychological distress (Coffey et al. 2009, 1065, 1066). However, post-surgical protocol does not emphasize psychological treatment regardless of the trauma associated with an amputation. Between poor outcomes and, what is argued in this thesis, inadequate treatment plans, re-evaluating protocol is necessary. Online health forums are becoming increasingly common, and thus I chose to look into the reddit forum r/amputee in order to further understand diabetic amputee’s unfulfilled needs and their lived experiences. 376 posts were coded for on reddit for different topics related to diabetic amputations. This thesis discusses the analysis of theses posts through a quality of life lens and explains themes that surfaced relating to socioeconomics and nutrition, mobility, psychological implications, and in the context of current treatment plans and online health communication. Ultimately, this reddit forum indicated a void in the current post-surgical protocol that must be filled, specifically in regards to psychological care. Analysis also demonstrated a willingness to participate in online health communication, and the potential to expand sites like reddit via maintaining peer to peer communication while adding the guidance of healthcare professionals to the site, as an avenue to improve the quality of life for diabetic amputees.

Table of Contents

Chapter 1.0: Introduction ………………………………………………………………………………………………..1

 

Chapter 2.0: Methods ……………………………………………………………………………………………………...8

           2.1: A note about reddit ……………………………………………………………………………………......8

           2.2: Data Collection and Coding Categories …………………………………………………………….9

           2.3: Data Processing and Results………………………………………………………………………….15

           2.4: Limitations ………………………………………………………………………………………………….17

 

Chapter 3.0: Non-Social Psychological Factors of Diabetic Amputations ……………………….…18

           3.10: Socioeconomics …………………………………………………………………………………………18

           3.20: Nutrition……………………………………………………………………………………………………22

                       3.21: Socioeconomic Factors and Nutrition ………………………………………………23

                       3.22: A note about diet more generally ……………………………………………………..25

                       3.23: Biology of Nutrition for Diabetic Amputations …………………………………..28

           3.3: Conclusion …………………………………………………………………………………………………..31

 

Chapter 4.0: Diabetic Amputation Mobility Ramifications ……………………………………………….32

           4.1: Neuropathy and Precursors to Amputation and their Effect on Mobility …………32

           4.2: General Mobility Ramifications …………………………………………………………………….38

           4.3: Prosthetics and Mobility Aids ……………………………………………………………………….44

           4.4: Conclusion …………………………………………………………………………………………………..49

 

Chapter 5.0: Social Psychological Factors of Diabetic Amputations ………………………………….50

           5.1: Phantom Limb Pain ……………………………………………………………………………………...50

           5.2: Psychological Implications of Amputations …………………………………………………...52

           5.3: Community Appreciation ……………………………………………………………………………..60

           5.4: Role of a Caregiver ……………………………………………………………………………………….64

           5.5 Conclusion …………………………………………………………………………………………………...66

 

Chapter 6.0: Current Educational Programs and Non-Traditional Methods of Treatment …67

           6.1: Educational Programs ………………………………………………………………………………….67

           6.2: Online Health Communication …………………………………………………………..………….70

           6.3: Conclusion……………………………………………………………………………………………..…….75

 

Chapter 7.0: Conclusion and Non-Medical Treatment Intervention ………………………………….77

 

References ...…………………………………………………………………………………………………………………82

About this Honors Thesis

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School	Emory College
Department	Interdisciplinary Studies in Society and Culture
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Rehabilitation and Therapy
Keyword	Diabetic Amputation
Committee Chair / Thesis Advisor	Mark Risjord, Emory University
Committee Members	Minsu Kim, Emory University Arri Eisen, Emory University

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