Lower limb amputations sustained during COVID-19 : patients’ narrative

Abstract

The aim of this research study is to explore whether the COVID-19 pandemic had an indirect impact on patients living with type 2 diabetes mellitus who sustained a lower limb amputation during the pandemic period in Malta and to analyse the health-seeking behaviours and experiences of such patients since locally there are still no research published regarding this phenomenon. Methods A qualitative design was employed in this research study, utilising an exploratory method consisting of semi-structured interviews amongst 10 patients who sustained a lower limb amputation during the COVID-19 pandemic between July 2020 and December 2022. The semi-structured interviews were recorded via an audio recorder to create full transcripts for analysis. The transcripts were then translated from Maltese to English using the back translation method. Inductive thematic analysis was used to identify themes and patterns across the qualitative data by thoroughly and repeatedly reading each transcript. Emergent themes were coded and similar codes were grouped into superordinate themes which were then grouped into categories. Results This study has identified the various indirect consequences of the COVID-19 pandemic on patients living with diabetes which could have potentially led to their lower limb amputation. Such indirect repercussions were experienced through disruptions in healthcare access and delivery or altered health-seeking behaviour or both. The main findings that emerged from this study were grouped into six superordinate themes; two of these themes belonged to one category titled “Shortcomings through the healthcare system” and the remaining four themes belonged to the other category, titled “Shortcomings through patient attitudes”. Conclusion The findings of this study concluded that individuals with diabetes who sustained a lower limb amputation during the COVID-19 pandemic were indirectly affected by the pandemic, either through the disruption in the healthcare services or through their altered health-seeking behaviour and attitudes. These indirect effects could have potentially resulted in aforementioned individuals’ lower limb amputation. Hence, it is crucial to highlight the indirect effects of the COVID-19 pandemic which are still being encountered today despite the fact that four years have already passed since the COVID-19 outbreak, in order to prevent similar repercussions should similar situations arise in the future.