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Quality of Life in Portuguese Patients with Diabetic Foot Ulcer Before and After an Amputation Surgery



Diabetic foot ulcer (DFU) including amputation surgery has serious consequences for patients, the family and healthcare services. DFU affects not only the physical health-related quality of life (HRQoL) of patients but also their mental well-being. The aims of this study were to find the predictors of HRQoL after surgery, to analyse differences in HRQoL, before and after surgery, and to explore the moderating role of a first versus previous amputation(s) in the relationship between physical and mental HRQoL, before and after surgery, in patients with DFU.


A longitudinal study comprising 108 Portuguese patients was conducted during the period of hospitalization before the surgery and at a follow-up consultation. Participants completed a socio-demographic questionnaire and the SF-36 to assess HRQoL.


Physical and mental HRQoL before surgery predicted HRQoL after surgery, as well as the number of diabetes complications and having received a re-amputation. Physical HRQoL decreased after surgery, but there were no differences on mental HRQoL. Having a previous amputation was a moderator between physical and mental HRQoL before and after surgery.


The results help to identify the most vulnerable patients at risk of having lower HRQoL after surgery, allowing interventions to be tailored to patients’ needs in order to promote their quality of life.

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The authors gratefully acknowledge the contributions of the Multidisciplinary Diabetic Foot Clinics of the following hospitals: CHP, CHSJ, CHVNG/E, CHTS, ULSAM and the Vascular Surgery Departments in Braga and CHSJ Hospitals. The authors also wish to thank all patients who agreed to participate in this study. This study was conducted at Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This work was supported by a grant (SFRH/BD/87704/2012) from the Portuguese Foundation for Science and Technology.

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Correspondence to Susana Pedras.

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The authors report that the current study conformed to the Helsinki Declaration concerning human rights and informed consent and followed correct procedures concerning the treatment of humans and animals in research.

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Pedras, S., Carvalho, R. & Pereira, M.G. Quality of Life in Portuguese Patients with Diabetic Foot Ulcer Before and After an Amputation Surgery. Int.J. Behav. Med. 23, 714–721 (2016).

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  • Diabetic foot ulcer
  • Amputation
  • Health-related quality of life