Disability and Quality of Life in Canadian Aboriginal and Non-Aboriginal Diabetic Lower-Extremity Amputees

Abstract

Meatherall BL, Garrett MR, Kaufert J, Martin BD, Fricke MW, Arneja AS, Duerksen F, Koulack J, Fong HM, Simonsen JN, Nicolle LE, Trepman E, Embil JM. Disability and quality of life in Canadian Aboriginal and non-Aboriginal diabetic lower-extremity amputees. Objective To compare and contrast disability and quality of life (QOL) in Aboriginal and non-Aboriginal subjects with diabetes who had lower-extremity amputation (LEA) and were living in urban and rural communities in Canada. Design Descriptive study using an interviewer-administered questionnaire and hospital medical record review. Setting Tertiary care center. Participants Forty-four diabetic subjects (minimum age, 18y) not receiving dialysis, including 21 Aboriginal (8 urban, 13 rural) and 23 non-Aboriginal (16 urban, 7 rural) subjects. Subjects were living in their current residence and had undergone LEA above the level of the ankle 6 months or more before interview. Interventions Not applicable. Main Outcome Measures Qualitative and quantitative data about symptoms, impairment, and QOL. Results Aboriginal subjects were younger than non-Aboriginal subjects at the time of diabetes diagnosis (Aboriginal, 42±10y; non-Aboriginal, 52±14y; P<.005) and first major LEA (Aboriginal, 57±7y; non-Aboriginal, 64±11y; P<.015). All subjects received rehabilitation after amputation. More rural non-Aboriginal subjects (83%) used their prosthesis both in and outside the home for all movements than other subjects ( P<.048). Rural non-Aboriginal subjects had the lowest and urban non-Aboriginal subjects had the highest frequency of walking-aid use outside the home. Assistance with personal care was required by a minority of subjects, but assistance with daily housework was required by the majority of subjects. Qualitative analysis revealed that participants were, in most cases, comfortable with their postamputation life. Conclusions Although the majority of participants in this study generally felt satisfied with their current status, major functional changes were noted after LEA that had a large negative impact on QOL.