Abstract:

Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot，providing a basis for medical staff to formulate intervention strategies. Methods A convergent mixed study design was used. A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life. During the same period，15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism. Results Quantitative findings：A total of 167 valid questionnaires were retrieved, and the recovery rate of valid questionnaires was 99.4%. the total quality of life score of 167 respondents was（84.22±12.49） scores；the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot（P<0.05）. Qualitative findings：a total of 3 themes were extracted based on the triadic interactive determinism，including subject level，environmental level and behavioural level. Mixed findings：age and amputation affect the physical and mental state of patients and hinders quality of life improvement；limited work and life，and scarce external resources；the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life. Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree，and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients，while also focusing on their individual needs and providing support.

Key words: Diabetic Foot, Amputation, Aged, Quality of Life, Ternary Interaction Determinism, Nursing Care, Mixed-Method Study

摘要：

目的 调查老年糖尿病足小截肢患者生活质量现状及影响因素，为医护人员制订干预策略提供依据。 方法 采用聚敛式混合研究设计，便利选取2022年5月—2024年5月北京市某三级甲等综合医院创面修复科收治的168例老年糖尿病足小截肢患者进行问卷调查，并对其生活质量的影响因素进行多元线性回归分析；同期，基于三元交互决定论，采用目的抽样法，选取15例患者进行半结构式访谈。 结果 量性研究结果：回收有效问卷167份，有效问卷回收率为99.4%。研究对象的生活质量总分为（84.22±12.49）分；多元线性回归分析结果显示，年龄及自理能力是老年糖尿病足小截肢患者生活质量的影响因素（P<0.05）。质性研究结果：基于三元交互决定论共提炼出主体层面、环境层面以及行为层面3个主题。混合研究结果：年龄和截肢影响患者的身心状态，生活质量提升受阻；工作生活受限，外部资源匮乏；自理能力水平制约患者的自我管理行为，生活质量提升困难。 结论 老年糖尿病足小截肢患者的生理和心理健康存在一定程度受损，医护人员在关注小截肢对老年糖尿病足患者生活质量产生不良影响的同时，也应关注其个体需求，并给予针对性的支持。

关键词: 糖尿病足, 截肢, 老年人, 生活质量, 三元交互决定论, 护理, 混合研究