Araştırma Makalesi
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“Bedenim de Ruhum da Eksik”: Ampütasyon Deneyimi Olan Hastaların Bakım Gereksinimleri ve Yaşadığı Güçlükler

Yıl 2024, Cilt: 8 Sayı: 2, 191 - 201, 30.08.2024
https://doi.org/10.25048/tudod.1469602

Öz

Amaç: Ampütasyon, dolaşım sistemi sorunları, kazalar, kanserler, enfeksiyonlar ve doğumsal anomalilere bağlı uygulanan cerrahi girişimler gibi nedenlerle sıklıkla yapılmakta ve bireyleri psikososyal olarak etkilemektedir. Bu araştırma, bireylerin ampütasyon deneyimlerinin ve bakım gereksinimlerinin daha iyi anlaşılması amacıyla yapılmıştır.
Yöntem: Nitel araştırma desenlerinden tanımlayıcı fenomenolojik tipteki araştırma Kasım 2023- Ocak 2024 tarihleri arasında 13 katılımcı ile yapılmıştır.
Bulgular: Katılımcıların 10’u erkek, 9’u evli, 11’i protez kullanmıyor ve yaş ortalaması 54,4’tür. Tematik analizde “Fiziksel etkiler”, “Sosyoekonomik etkiler”, “Uyum ve baş etme”, “Duygusal etkiler”, Ampütasyon algısı” ve “Protez Algısı” olmak üzere altı tema elde edilmiştir. Katılımcıların çoğu günlük yaşam aktivitelerinde bağımlıdır. Ampütasyon sonrası yaşanan beden imajı etkilenimi, kayıp ve çaresizlik gibi duygusal zorluklar, sosyal izolasyon ve bağımlılık duygusu birçok kişiyi etkilemiştir. Katılımcılar sıklıkla aile ve sağlık uzmanları gibi destek sistemlerinin önemini vurgulamıştır. Özellikle aile üyelerinden destek almak, bireylerin ampütasyon sonrası uyum sürecinde önemli bir rol oynamıştır. Katılımcıların tamamına yakını amputasyonu olumsuz algılamıştır. Bununla birlikte protez kullanan katılımcıların daha olumlu ifadeler kullandığı dikkat çekmiştir. Katılımcıların birçoğu protez kullanma isteklerinden ve protezin yaşamlarını olumlu etkileyeceğine dair umutlarından bahsetmiştir.
Sonuç: Ampütasyon akut veya kronik sağlık sorunları nedeniyle yapılan ve bireyleri biyopsikososyal olarak etkileyen önemli bir ameliyattır. Bireylerin ampütasyonlu bir ekstiremiteyle yaşamaya uyum sağlayabilmesinde perioperatif hazırlık ve bakım süreci ve destek sistemlerinin etkisi büyüktür. Bireylerin yaşamını kolaylaştırıcı protezlerin uygulanması, yeni beceriler kazandırılması ve rehabilitasyon süreci uyumu kolaylaştıracak diğer faktörlerdir.

Kaynakça

  • 1. Steinberg N, Gottlieb A, Siev-Ner I, Plotnik M. Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery – a systematic review, Disability and Rehabilitation 2019;41(15):1778-1787, doi:10.1080/09638288.2018.1449258
  • 2. Özdemir FE, Yılmaz M. Diz Altı Amputasyonu Olan Hastanın Ida Jean Orlando’nun Etkileşim Modeline Göre Hemşirelik Bakımı: Olgu Sunumu. ERÜ Sağlık Bilimleri Fakültesi Dergisi 2022; 9(1):14-22.
  • 3. Kacmaz KS, Polat K, Uçurum SG. Depremle İlişkili Rabdomiyaliz Geçiren Hastada Ampute Rehabilitasyonu. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2023;8(2): 635- 640.
  • 4. Luza LP, Ferreira EG, Minsky RC, Pires GKW, da Silva R. Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies. Disability and Rehabilitation: Assistive Technology 2020;15(5): 582-589.
  • 5. Schober TL, Abrahamsen C. Patient perspectives on major lower limb amputation–A qualitative systematic review. International Journal of Orthopaedic and Trauma Nursing 2022;100958.
  • 6. Behera P, Dash M. Life after lower limb amputation: a meta- aggregative systemic review of the effect of amputation on amputees. Journal of Disability Studies 2021;7(2):90-96.
  • 7. Murray CD, Forshaw MJ. The experience of amputation and prosthesis use for adults: a metasynthesis. Disability and rehabilitation 2013;35(14):1133-1142.
  • 8. Jędrzejkiewicz B. Nursing care of a patient after limb amputation- case study. Journal of Education, Health and Sport 2019;9(9):424-429.
  • 9. Kwah LK, Green J, Butler J, Lam L. Quality of clinical practice guidelines for management of limb amputations: a systematic review. Physical Therapy 2019;99(5):577-590.
  • 10. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research (3nd ed.). Thousand Oaks, CA 2017: Sage.
  • 11. Baltacı, A. (2018). Nitel araştırmalarda örnekleme yöntemleri ve örnek hacmi sorunsalı üzerine kavramsal bir inceleme. Bitlis Eren Üniversitesi Sosyal Bilimler Dergisi, 7(1), 231-274.
  • 12. Canbolat Seyman, C., & Uzar Ozcetin, Y. S. (2022). “I wish I could have my leg”: a qualitative study on the experiences of individuals with lower limb amputation. Clinical Nursing Research, 31(3), 509-518.
  • 13. Miller MJ, Morris MA, Magnusson DM, Putnam K, Cook PF, Schenkman ML, Christiansen CL. Psychosocial factors influence physical activity after dysvascular amputation: a convergent mixed‐methods study. PM&R 2021;13(7), 737-745.
  • 14. Crocker RM, Palmer KN, Marrero DG, Tan TW. Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. Journal of Diabetes and its Complications 2021;35(8):107960.
  • 15. Abouammoh N, Aldebeya W, Abuzaid R. Experiences and needs of patients with lower limb amputation in Saudi Arabia: a qualitative study. Eastern Mediterranean Health Journal 2021;27(4): 407-413.
  • 16. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77–101. https:// doi.org/10.1191/1478088706qp063oa
  • 17. Günbayi I. Job Stressors and Their Effects on Academic Staff: A Case Study. Online Submission 2014;5(4):58-73.
  • 18. Çelebi, M., Orman, F. Nitel araştırma yöntemleri. Ankara: Pegem Akademi. 2021
  • 19. Yıldırım, A., Şimşek, H. Nitel Araştırmalarda geçerlik ve Güvenirlik (in Sosyal Bilimlerde Nitel Araştırma Yöntemleri). Seçkin Akademik ve Mesleki Yayınlar, Ankara, 12. Baskı, 2021;269-299.
  • 20. Chopra A, Azarbal AF, Jung E, Abraham CZ, Liem TK, Landry GJ., ... & Mitchell EL. Ambulation and functional outcome after major lower extremity amputation. Journal of vascular surgery 2018;67(5), 1521-1529.
  • 21. MacKay C, Cimino SR, Guilcher SJ, Mayo AL, Devlin M, Dilkas S, ... & Hitzig SL. A qualitative study exploring individuals’ experiences living with dysvascular lower limb amputation. Disability and rehabilitation 2022;44(10):1812-1820.
  • 22. Mundell BF, Luetmer MT, Kremers HM, Visscher S, Hoppe KM, Kaufman KR. The risk of major cardiovascular events for adults with transfemoral amputation. Journal of neuroengineering and rehabilitation 2018;15:1-7.
  • 23. Warburton DE, Bredin SS. Health benefits of physical activity: a systematic review of current systematic reviews. Current opinion in cardiology, 2017;32(5): 541-556.
  • 24. Polat CS, Konak HE, Altas EU, Akıncı MG, Onat S. Factors related to phantom limb pain and its effect on quality of life. Somatosensory & motor research 2021;38(4): 322-326.
  • 25. Kuffler DP. Coping with phantom limb pain. Molecular neurobiology 2018;55: 70-84.
  • 26. Poscia A, Stojanovic J, La Milia DI, Duplaga M, Grysztar M, Moscato U, ... & Magnavita N. Interventions targeting loneliness and social isolation among the older people: An update systematic review. Experimental gerontology 2018;102: 133- 144.
  • 27. Keeves J, Hutchison A, D’Cruz K, Anderson S. Social and community participation following traumatic lower limb amputation: an exploratory qualitative study. Disability and Rehabilitation 2023;45(26): 4404-4412.
  • 28. Brier MJ, Williams RM, Turner AP, Henderson AW, Roepke AM, Norvell DC, ... & Czerniecki JM. Quality of relationships with caregivers, depression, and life satisfaction after dysvascular lower extremity amputation. Archives of physical medicine and rehabilitation 2018;99(3):452-458.ca
  • 29. Calabrese L, Maffoni M, Torlaschi V, Pierobon A. What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons. In Healthcare 2023, June ;11(11):1661. MDPI
  • 30. Pedras S, Vilhena E, Carvalho R, Pereira MG. Psychosocial adjustment to a lower limb amputation ten months after surgery. Rehabilitation Psychology 2018;63(3): 418.
  • 31. Şimsek N, Öztürk G, Nahya ZN. The mental health of individuals with post-traumatic lower limb amputation: a qualitative study. Journal of patient experience 2020;7(6): 1665-1670.
  • 32. Demirdel S, Ülger Ö. Body image disturbance, psychosocial adjustment and quality of life in adolescents with amputation. Disability and Health Journal 2021;14(3):101068.
  • 33. Washington ED, Williams AE. 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. Prosthetics and orthotics international 2016;40(1):44-50.
  • 34. Lathouwers E, Díaz MA, Maricot A, Tassignon B, Cherelle C, Cherelle P, ... & De Pauw K. Therapeutic benefits of lower limb prostheses: a systematic review. Journal of NeuroEngineering and Rehabilitation 2023;20(1):4.

"Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation

Yıl 2024, Cilt: 8 Sayı: 2, 191 - 201, 30.08.2024
https://doi.org/10.25048/tudod.1469602

Öz

Introduction: It is frequently performed for reasons such as amputation, circulatory system problems, accidents, cancers, infections and surgical interventions due to congenital anomalies, and it affects individuals psychosocially. This research was conducted to better understand individuals' amputation experiences and care needs.
Methods: Descriptive phenomenological type research, one of the qualitative research designs, was conducted with 13 participants between November 2023 and January 2024.
Results: 10 of the participants are male, 9 are married, 11 do not use prosthesis, and the average age is 54.4. Six themes were obtained in the thematic analysis: "Physical effects", "Socioeconomic effects", "Adaptation and coping", "Emotional effects", Amputation perception" and "Prosthesis Perception". Most of the participants are dependent in their daily living activities. Post-amputation body image impact, emotional difficulties such as loss and helplessness, and feelings of social isolation and dependency have affected many people. Participants frequently emphasized the importance of support systems such as family and healthcare professionals. In particular, receiving support from family members played an important role in the adaptation process of individuals after amputation. Almost all of the participants perceived amputation negatively. However, it was noted that participants using prosthesis used more positive expressions. Many of the participants talked about their desire to use a prosthesis and their hope that the prosthesis would have a positive impact on their lives.
Conclusion: Amputation is an important surgery performed due to acute or chronic health problems and affects individuals biopsychosocially. Perioperative preparation and care processes and support systems have a great impact on individuals' ability to adapt to living with an amputated limb. The application of prostheses that make life easier for individuals, gaining new skills and the rehabilitation process are other factors that will facilitate adaptation.

Etik Beyan

The authors state that this research has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.

Destekleyen Kurum

The research has no funding.

Teşekkür

We would like to thank the patients who participated in the study for their candid shares.

Kaynakça

  • 1. Steinberg N, Gottlieb A, Siev-Ner I, Plotnik M. Fall incidence and associated risk factors among people with a lower limb amputation during various stages of recovery – a systematic review, Disability and Rehabilitation 2019;41(15):1778-1787, doi:10.1080/09638288.2018.1449258
  • 2. Özdemir FE, Yılmaz M. Diz Altı Amputasyonu Olan Hastanın Ida Jean Orlando’nun Etkileşim Modeline Göre Hemşirelik Bakımı: Olgu Sunumu. ERÜ Sağlık Bilimleri Fakültesi Dergisi 2022; 9(1):14-22.
  • 3. Kacmaz KS, Polat K, Uçurum SG. Depremle İlişkili Rabdomiyaliz Geçiren Hastada Ampute Rehabilitasyonu. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2023;8(2): 635- 640.
  • 4. Luza LP, Ferreira EG, Minsky RC, Pires GKW, da Silva R. Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies. Disability and Rehabilitation: Assistive Technology 2020;15(5): 582-589.
  • 5. Schober TL, Abrahamsen C. Patient perspectives on major lower limb amputation–A qualitative systematic review. International Journal of Orthopaedic and Trauma Nursing 2022;100958.
  • 6. Behera P, Dash M. Life after lower limb amputation: a meta- aggregative systemic review of the effect of amputation on amputees. Journal of Disability Studies 2021;7(2):90-96.
  • 7. Murray CD, Forshaw MJ. The experience of amputation and prosthesis use for adults: a metasynthesis. Disability and rehabilitation 2013;35(14):1133-1142.
  • 8. Jędrzejkiewicz B. Nursing care of a patient after limb amputation- case study. Journal of Education, Health and Sport 2019;9(9):424-429.
  • 9. Kwah LK, Green J, Butler J, Lam L. Quality of clinical practice guidelines for management of limb amputations: a systematic review. Physical Therapy 2019;99(5):577-590.
  • 10. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research (3nd ed.). Thousand Oaks, CA 2017: Sage.
  • 11. Baltacı, A. (2018). Nitel araştırmalarda örnekleme yöntemleri ve örnek hacmi sorunsalı üzerine kavramsal bir inceleme. Bitlis Eren Üniversitesi Sosyal Bilimler Dergisi, 7(1), 231-274.
  • 12. Canbolat Seyman, C., & Uzar Ozcetin, Y. S. (2022). “I wish I could have my leg”: a qualitative study on the experiences of individuals with lower limb amputation. Clinical Nursing Research, 31(3), 509-518.
  • 13. Miller MJ, Morris MA, Magnusson DM, Putnam K, Cook PF, Schenkman ML, Christiansen CL. Psychosocial factors influence physical activity after dysvascular amputation: a convergent mixed‐methods study. PM&R 2021;13(7), 737-745.
  • 14. Crocker RM, Palmer KN, Marrero DG, Tan TW. Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. Journal of Diabetes and its Complications 2021;35(8):107960.
  • 15. Abouammoh N, Aldebeya W, Abuzaid R. Experiences and needs of patients with lower limb amputation in Saudi Arabia: a qualitative study. Eastern Mediterranean Health Journal 2021;27(4): 407-413.
  • 16. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77–101. https:// doi.org/10.1191/1478088706qp063oa
  • 17. Günbayi I. Job Stressors and Their Effects on Academic Staff: A Case Study. Online Submission 2014;5(4):58-73.
  • 18. Çelebi, M., Orman, F. Nitel araştırma yöntemleri. Ankara: Pegem Akademi. 2021
  • 19. Yıldırım, A., Şimşek, H. Nitel Araştırmalarda geçerlik ve Güvenirlik (in Sosyal Bilimlerde Nitel Araştırma Yöntemleri). Seçkin Akademik ve Mesleki Yayınlar, Ankara, 12. Baskı, 2021;269-299.
  • 20. Chopra A, Azarbal AF, Jung E, Abraham CZ, Liem TK, Landry GJ., ... & Mitchell EL. Ambulation and functional outcome after major lower extremity amputation. Journal of vascular surgery 2018;67(5), 1521-1529.
  • 21. MacKay C, Cimino SR, Guilcher SJ, Mayo AL, Devlin M, Dilkas S, ... & Hitzig SL. A qualitative study exploring individuals’ experiences living with dysvascular lower limb amputation. Disability and rehabilitation 2022;44(10):1812-1820.
  • 22. Mundell BF, Luetmer MT, Kremers HM, Visscher S, Hoppe KM, Kaufman KR. The risk of major cardiovascular events for adults with transfemoral amputation. Journal of neuroengineering and rehabilitation 2018;15:1-7.
  • 23. Warburton DE, Bredin SS. Health benefits of physical activity: a systematic review of current systematic reviews. Current opinion in cardiology, 2017;32(5): 541-556.
  • 24. Polat CS, Konak HE, Altas EU, Akıncı MG, Onat S. Factors related to phantom limb pain and its effect on quality of life. Somatosensory & motor research 2021;38(4): 322-326.
  • 25. Kuffler DP. Coping with phantom limb pain. Molecular neurobiology 2018;55: 70-84.
  • 26. Poscia A, Stojanovic J, La Milia DI, Duplaga M, Grysztar M, Moscato U, ... & Magnavita N. Interventions targeting loneliness and social isolation among the older people: An update systematic review. Experimental gerontology 2018;102: 133- 144.
  • 27. Keeves J, Hutchison A, D’Cruz K, Anderson S. Social and community participation following traumatic lower limb amputation: an exploratory qualitative study. Disability and Rehabilitation 2023;45(26): 4404-4412.
  • 28. Brier MJ, Williams RM, Turner AP, Henderson AW, Roepke AM, Norvell DC, ... & Czerniecki JM. Quality of relationships with caregivers, depression, and life satisfaction after dysvascular lower extremity amputation. Archives of physical medicine and rehabilitation 2018;99(3):452-458.ca
  • 29. Calabrese L, Maffoni M, Torlaschi V, Pierobon A. What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons. In Healthcare 2023, June ;11(11):1661. MDPI
  • 30. Pedras S, Vilhena E, Carvalho R, Pereira MG. Psychosocial adjustment to a lower limb amputation ten months after surgery. Rehabilitation Psychology 2018;63(3): 418.
  • 31. Şimsek N, Öztürk G, Nahya ZN. The mental health of individuals with post-traumatic lower limb amputation: a qualitative study. Journal of patient experience 2020;7(6): 1665-1670.
  • 32. Demirdel S, Ülger Ö. Body image disturbance, psychosocial adjustment and quality of life in adolescents with amputation. Disability and Health Journal 2021;14(3):101068.
  • 33. Washington ED, Williams AE. 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. Prosthetics and orthotics international 2016;40(1):44-50.
  • 34. Lathouwers E, Díaz MA, Maricot A, Tassignon B, Cherelle C, Cherelle P, ... & De Pauw K. Therapeutic benefits of lower limb prostheses: a systematic review. Journal of NeuroEngineering and Rehabilitation 2023;20(1):4.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi, Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Emine Selda Gündüz 0000-0002-1399-7722

Melike Durmaz 0000-0002-6028-5592

Bahattin Kerem Aydın 0000-0002-0973-3249

Yayımlanma Tarihi 30 Ağustos 2024
Gönderilme Tarihi 17 Nisan 2024
Kabul Tarihi 4 Temmuz 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 8 Sayı: 2

Kaynak Göster

APA Gündüz, E. S., Durmaz, M., & Aydın, B. K. (2024). "Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation. Türkiye Diyabet Ve Obezite Dergisi, 8(2), 191-201. https://doi.org/10.25048/tudod.1469602
AMA Gündüz ES, Durmaz M, Aydın BK. "Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation. Turk J Diab Obes. Ağustos 2024;8(2):191-201. doi:10.25048/tudod.1469602
Chicago Gündüz, Emine Selda, Melike Durmaz, ve Bahattin Kerem Aydın. “‘Both My Body and My Spirit Are Incomplete’: Care Needs and Difficulties Experienced by Patients With Amputation”. Türkiye Diyabet Ve Obezite Dergisi 8, sy. 2 (Ağustos 2024): 191-201. https://doi.org/10.25048/tudod.1469602.
EndNote Gündüz ES, Durmaz M, Aydın BK (01 Ağustos 2024) "Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation. Türkiye Diyabet ve Obezite Dergisi 8 2 191–201.
IEEE E. S. Gündüz, M. Durmaz, ve B. K. Aydın, “‘Both My Body and My Spirit are Incomplete’: Care Needs and Difficulties Experienced by Patients with Amputation”, Turk J Diab Obes, c. 8, sy. 2, ss. 191–201, 2024, doi: 10.25048/tudod.1469602.
ISNAD Gündüz, Emine Selda vd. “‘Both My Body and My Spirit Are Incomplete’: Care Needs and Difficulties Experienced by Patients With Amputation”. Türkiye Diyabet ve Obezite Dergisi 8/2 (Ağustos 2024), 191-201. https://doi.org/10.25048/tudod.1469602.
JAMA Gündüz ES, Durmaz M, Aydın BK. "Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation. Turk J Diab Obes. 2024;8:191–201.
MLA Gündüz, Emine Selda vd. “‘Both My Body and My Spirit Are Incomplete’: Care Needs and Difficulties Experienced by Patients With Amputation”. Türkiye Diyabet Ve Obezite Dergisi, c. 8, sy. 2, 2024, ss. 191-0, doi:10.25048/tudod.1469602.
Vancouver Gündüz ES, Durmaz M, Aydın BK. "Both My Body and My Spirit are Incomplete": Care Needs and Difficulties Experienced by Patients with Amputation. Turk J Diab Obes. 2024;8(2):191-20.

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