The interplay of Fatalism, Death Anxiety, and Treatment Compliance in patients with diabetes WHO have undergone amputation: a mixed-METHODS study

Abstract

This study aimed to investigate the relationship between fatalism, death anxiety, and compliance with type 2 diabetes mellitus (T2DM) treatment in patients who had undergone limb amputation due to diabetic complications. METHODS: A mixed-method design was used, combining quantitative and qualitative data. The sample consisted of 93 patients with diabetes who had undergone amputation and who completed surveys, and 20 who participated in in-depth interviews. Qualitative data were analyzed using a phenomenological approach. Scales included the Fatalism Scale, Thorson-Powell Death Anxiety Scale, and the T2DM Treatment Compliance Scale. RESULTS: Significant differences were observed across education levels in death anxiety, treatment compliance, and fatalism ( P P P =.072). Qualitative findings supported these results and identified 3 main concepts: challenges in adapting to amputation, managing diabetes treatment, and psychological and belief-based challenges. Three themes were identified: issues with adapting to the condition, treatment adherence, and fatalism, death anxiety, and psychological effects. CONCLUSIONS: Fatalism plays a crucial role in treatment compliance for diabetic foot and amputation-related DM, whereas the impact of death anxiety is less direct. To improve compliance, addressing fatalistic beliefs and providing psychological support is essential. Tailored interventions, including psychological counseling and patient-specific educational programs, could significantly enhance adherence in amputated diabetic patients.