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Familia, economía y servicios sanitarios: claves de los cuidados en pacientes con diabetes y amputación de miembros inferiores. Estudio cualitativo en Andalucía: [Family, socioeconomic status and health services: Clues to health care in diabetic patients with lower limb amputations in Andalusia. A qualitative study]
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Consejería de Salud de la Junta de Andalucía. Delegación Territorial de Cádiz, Espana.
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2017 (Spanish)In: Atención Primaria, ISSN 0212-6567, E-ISSN 1578-1275Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To examine the experience of diabetic care in patients undergoing lower limb amputation.

Design: A qualitative study using the phenomenological approach.

Setting: Cadiz Health District.

Participants: A total of 16 patients (11 men and 5 women) diagnosed with diabetes mellitus type 2 and with non-traumatic lower limb amputation.

Methods: Semi-structured interviews were performed, followed by a content analysis according Graneheim and Lundman.

Results: Four categories were identified: 1. The family is the cornerstone for diabetic care. 2. The socio-economic and working conditions determine the quality of self-care. 3. The patient-health professional interaction facilitates patient care. 4. Limitations in the provision of health services.

Conclusion: Family, economic and working conditions, along with health system-related factors are the most important elements in the care of patients with diabetes and amputations. Social, economic and working conditions determine diabetic complications. In order to enhance health care impact on the prevention of diabetes mellitus complications, health system policy makers must take these facts seriously into consideration and in a more personalised manner.

Abstract [es]

Objetivo: Explorar la vivencia de los cuidados diabéticos en pacientes sometidos a amputación de miembros inferiores por pie diabético.

Diseño: Estudio cualitativo con perspectiva fenomenológica.

Emplazamiento: Área hospitalaria de Cádiz.

Participantes: Dieciséis participantes (11 hombres y 5 mujeres) con diabetes tipo 2 y amputación no traumática de miembros inferiores.

Métodos: Entrevistas semiestructuradas individuales y análisis de contenido de la información usando el método propuesto por Graneheim y Lundman.

Resultados: Se identificaron 4 categorías: 1. La familia es la piedra angular de los cuidados; 2. Los aspectos socioeconómicos y laborales determinan la calidad de los autocuidados; 3. La interacción paciente-personal de salud dinamiza los cuidados; y 4. Las limitaciones en la provisión de servicios sanitarios.

Conclusión: La familia, la situación económica y laboral y los factores del sistema sanitario constituyen los elementos más relevantes en los cuidados de pacientes con diabetes y amputación de miembros inferiores. Los determinantes sociales, económicos y laborales deben ser tomados en especial consideración y de manera más personalizada desde los servicios sanitarios para aumentar el impacto de los cuidados proporcionados en la prevención de las complicaciones de la diabetes mellitus.

Place, publisher, year, edition, pages
2017.
Keyword [en]
Diabetes mellitus, Diabetic foot, Amputation, Self-care, Qualitative study
Keyword [es]
Diabetes mellitus, Pie diabético, Amputación, Autocuidados, Estudio cualitativo
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-144307DOI: 10.1016/j.aprim.2017.06.011PubMedID: 29150148OAI: oai:DiVA.org:umu-144307DiVA: diva2:1178925
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-01-31Bibliographically approved

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