title: An exploratory phenomenological study exploring the experiences of people with systemic disease who have undergone lower limb amputation and its impact on their psychological well-being.
abstract: BACKGROUND
  Amputation is a life-changing event accompanied by challenges for the affected person with time-dependent depression often used to quantify its level of impact on their psychological well-being. There are varied factors that contribute to this and its persistence. The aim of this study was to explore the experiences over time of people with diabetes and/or peripheral vascular disease following an amputation and the impact on their psychological well-being.
  
  
  OBJECTIVE
  To develop an understanding of the experience of living with an amputation and a chronic condition in order to help clinicians identify those in need of counselling support.
  
  
  METHODS
  A qualitative study utilising an iterative approach in line with the philosophy of interpretive phenomenology.
  
  
  METHODS
  Six participants who had experienced a lower limb amputation associated with peripheral vascular disease/diabetes were interviewed on two occasions (baseline and 4 months). An interpretative phenomenological approach was utilised for both data collection and analysis.
  
  
  RESULTS
  For these participants, amputation was part of the chronology of their chronic disease. It was the individual's variable experience of health which impacted their psychological well-being rather than the length of time since amputation.
  
  
  CONCLUSIONS
  The multivariable experience of amputation means that individually tailored counselling/psychological support is recommended.
  
  
  CONCLUSIONS
  An understanding of how the experience of living with an amputation and a chronic condition may change over time will help clinicians to identify the ongoing need for counselling support.
authors.affiliation: Directorate of Prosthetics, Orthotics and Podiatry, School of Health Sciences, University of Salford, UK e.d.washington@salford.ac.uk.
authors.forename: Elaine D
authors.initials: ED
authors.lastname: Washington
authors.affiliation: Directorate of Prosthetics, Orthotics and Podiatry, School of Health Sciences, University of Salford, UK.
authors.forename: Anita E
authors.initials: AE
authors.lastname: Williams
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000671:Amputation, Surgical / Q000379:methods / Q000523:psychology* / Q000534:rehabilitation; D001186:Artificial Limbs; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D036301:Qualitative Research; D011788:Quality of Life; D018570:Risk Assessment; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome
keywords: Psychological well-being; diabetes; interpretative phenomenology; lower limb amputation; patient experience; peripheral vascular disease