Traumatic stress as a mediator of quality of life and burden in informal caregivers of amputees due to diabetic foot: a longitudinal study.

Abstract

Background: Type 2 diabetes mellitus (DMT2) is frequently associated with complications that can lead to lower limb amputation, being the second major cause of amputation. The amputee becomes dependent on caregivers, who are often unprepared for this new role and face many challenges. Care-giving influences several dimensions of the caregiver's life. This study evaluates the mediating role of traumatic stress in the relationship between caregiver perceived stress and burden/quality of life (QoL) taking also into consideration the duration of caregiving and whether the caregiver receives help in caregiving tasks, in informal caregivers of amputees due to diabetic foot over a 10 month period.

Participants and procedure: The sample consisted of 110 informal caregivers of amputees due to diabetic foot with type 2 diabetes. This longitudinal study evaluates, at three time points, the mediating role of traumatic stress in the relationship between perceived stress and burden/quality of life considering the duration of caregiving and whether the caregiver received help and social support in caregiving tasks.

Results: The results showed that the duration of caregiving, help in caregiving and caregiver stress (T1) predicted traumatic stress seven months (T2) after patients' amputation; and traumatic stress (T2) predicted mental QoL and burden, 10 months later (T3).

Conclusions: This study emphasizes the importance of intervention in caregivers at the beginning of caregiving, to improve mental QoL and decrease the burden, ten months after amputation.