Between hope and despair: experiences of precariousness and precarity in the lived experiences of recent diabetic amputees in primary care

Abstract

Precariousness dominates the lives of patients with recent diabetic lower extremity amputations. Wound healing is not guaranteed, post-amputation mortality is high and personal and social identities are destabilised. This study explores the experiences of nine post-amputation diabetic patients in the context of Singapore’s primary health and social care and diversified cultural setting. The loss of physical integrity leads to the self being rendered precarious in multiple ways: emotional-existential precariousness results from uncertainty about survival; agentic precariousness, from restrictions to the individual’s autonomy; the social self is rendered precarious as social relations and identities are changed; and financial precarity, which arises from job insecurity and treatment cost. Patients act to overcome precariousness and regain agency in various ways. Supporting patients’ agency should be integral to all healthcare interventions, at whatever stage of the patient’s journey, and needs to take into account cultural roles and values.