Perception of patients with diabetes mellitus towards lower limb amputation in Thulamela Municipality of Vhembe District, Limpopo Province

Abstract

Diabetes mellitus is a major public health concern and a leading cause of morbidity and mortality worldwide, with its prevalence continuing to rise globally. As a chronic condition, diabetes mellitus significantly affects the quality of life of those living with it. Severe complications, such as diabetic foot ulcers and infections, frequently result in lower limb amputation, further compromising patients’ physical, psychological, and social well-being. This study aimed to explore the perceptions of patients living with diabetes mellitus regarding lower limb amputation in Thulamela Municipality, Vhembe District, Limpopo Province. A qualitative, exploratory, descriptive, and contextual research design was employed to obtain an in-depth understanding of participants’ experiences and perceptions. Non-probability purposive sampling was used to select 20 participants living with diabetes mellitus and those at risk of undergoing lower limb amputation. Data was collected using in-depth individual interviews which was after analysed using thematic analysis which was guided by the Health Belief Model which is suitable for understanding behaviors related to disease prevention and treatment adherence. Data trustworthiness was ensured through the application of credibility, dependability, confirmability, and transferability. Ethical approval was obtained from the University of Venda Ethics Committee and the relevant healthcare institutions. Informed consent was obtained from all participants, and confidentiality and anonymity were strictly maintained. The findings revealed that many patients delayed seeking medical care due to limited knowledge about diabetes mellitus, particularly regarding lifestyle modification and diabetic foot care. Cultural, religious, and social beliefs were identified as significant factors influencing health-seeking behaviour, with many participants initially consulting traditional healers before seeking care in clinics or hospitals. Acceptance of lower limb amputation often occurred only after experiencing severe pain and advanced infection. The study recommends strengthening health education on diabetic foot care, promoting collaboration with traditional healers and spiritual leaders, increasing community awareness to reduce stigma, and providing psychosocial support and counselling to enhance informed decision-making regarding lower limb amputation.