Traumatic stress symptoms following a lower limb amputation in diabetic patients: a longitudinal study

Abstract

Objective: Limited research has focussed on the development of traumatic stress symptoms following an amputation due to a chronic disease such as Diabetes. This study analysed whether coping strategies, anxiety and depression symptoms, sociodemographic and clinical variables were related to traumatic stress symptoms in a sample of patients who had undergone a lower limb amputation.

Design: A longitudinal design with three assessments, one month (T1), six (T2) and ten months after an amputation surgery (T3), included 144 patients.

Main outcome measures: IES-R, WOC and HADS.

Results: Traumatic stress symptoms were prevalent at T1 (M = 15.65, SD = 15.40) and probable PTSD was observed in 13.9% patients. Presence of pain, high level of anxiety symptoms and emotion-focused strategies contributed to traumatic stress symptoms, and the period between T1 and T2, was critical. Six to ten months (Λ = 0.871, F (2,84) =6.245, p=. 003), after surgery, symptoms tended to decrease 0.122 units (SE = 0.032, p = 0.002) per assessment.

Conclusions: Findings raise awareness to the need of urgent identification of traumatic stress symptoms in medically ill patients who underwent a lower limb amputation, given the prevalence of traumatic stress symptoms right after surgery and in the following six months.

Keywords: Traumatic stress symptoms; amputation; anxiety symptoms; coping strategies; diabetes.