RESPONSE AND KOPING PATIENT DIABETES MELLITUS POST AMPUTATION IN

ULIN HOSPITAL BANJARMASIN

Candra Kusuma1, Yati Afiyanti 2, Abd.basyid 3

1
Universitas Muhammadiyah Banjarmasin
2
Universitas Indonesia
3
STIKES Cahaya Bangsa Banajrmasin

Abstract

Background: DM disease is a health problem that is very important because it is associated

with a high incidence of complications and high mortality. For most people the disease diabetes
mellitus is a disease that is very worrying and the public aware of the magnitude of the potential
dangers caused. For individuals who suffer from diabetes mellitus with post-amputation, the next
life is a new round of challenges and changes, and will go through the process of coping with the
change process.
Objective: In general, this study aims to explore various diabetic patients experience post-
amputation of responses and coping experienced.
Methods: This study used a qualitative phenomenological study. Retrieving data using in depth
interview in four participants were treated diabetic foot clinic in Ulin Hospital Banjarmasin
equipped with a guidance interview and informed consent. The analytic method structure from
Creswell into 6 steps.
Results: There are 2 themes depicting various responses post-amputation and depicting various
coping DM patients post-amputation. Sub-Theme in depicting various responses post-
amputation namely: (1) Experiencing physical barriers, (2) Experiencing the changing role, (3)
Experiencing the grieving process, and are 4 Sub-theme depicting various coping DM patients
post-amputation namely: (1) More worship, (2) Accept the circumstances, (3) A strong
Motivation, (4) social support.

Keywords: Response, Coping, diabetes mellitus, amputation.

1

1. Introduction
Diabetes Mellitus (DM) is a
metabolic disease that is a collection
of symptoms that arise in a person
because of an increase in blood
glucose levels above the normal
value. This disease is caused by the
impaired glucose metabolism due to
lack of insulin either in absolute or
relative. According to Smeltzer &
Bare (2002) diabetes can be divided
into three types, Type I is insulin-
dependent diabetes mellitus or
Insulin Dependent Diabetes Mellitus
(IDDM), Type II diabetes mellitus is
not dependent insulin or Noninsulin
Dependent Diabetes Mellitus
(NIDDM) and diabetes Mellitus
Gestational Diabetes Mellitus
(GDM). DM disease is a serious
threat to society, if DM disease is
ignored and uncontrollable can cause
disease or other complications that
can be serious such as, hypertension,
kidney disorder, coronary heart, can
even end up in amputation and left
over time would cause death.
Davidson (2002) states that people
with diabetes mellitus whose
experience loss of limbs due to
amputation, expose the individual in
a variety of threats are increasingly
widespread, developing and full of
challenges to physical functions such
as weakness. Changes in physical
conditions in patients with DM who
experience amputation can cause
stress conditions. Stress that appears
in patients with DM post-amputation
can greatly affect the individual
coping mechanism (Mitra, 2008).
Coping is a person's effort or way to
reduce psychological stress in the
face of daily life problems that
require personal ability and support
2
from the environment, in order to
reduce stress (Rasmun, 2009).
The response and coping of each DM
patient varies, so there needs to be a
more in-depth study using qualitative
phenomenology studies. Based on
these descriptions, the question
arises as to what and how Response
and coping experienced by DM
sufferers in adapting to their daily
life after amputation.
2. Research Methods
This study used qualitative study
with phenomenological approach.
Phenomenology provides a deep
understanding of the phenomena as
experienced by some individuals.
Explore in depth and naturalistic of
patient DM post amputation. The
population on this study is post
amputation patients with diabetes
mellitus in diabetic foot Ulin
Hospital Banjarmasin clinic. The
samples used in this study were
patients with DM with post
amputation, which met the inclusion
criteria. The data is taken through in-
depth interviews using the interview
guidelines that have been prepared.
Analysis this study using Creswell
(2014).
3. Thematic analysis results
The theme analysis was obtained
from interviews in this study on
participant response and coping in
patients with DM post amputation.
Produces 2 main themes found such
as (1) various post amputation
responses, and (2) various coping of
DM post amputation patients. These
themes will the researchers re-
describe each sub-theme to gain an
understanding of how these two

themes are based on the experience
of the participant
Post amputation responses
(Theme1).
Experiencing barriers to activity
(sub-theme 1.1)
A participant below reveals the
impact of weakness is in his body,
this condition affects the function of
the participant's physical ability as a
supporting activity.
My body feels weak (P1)
This weakness leads to spontaneous
reactions and responses from the
immediate environment such as the
family that always accompanies the
participants. The presence of the
family in the life of the participant is
very important in the participant
perform daily activities. This is
expressed by the participants as
follows.
If the path is supported by the wife
(P3)
The next participant revealed that
there is interruption in the activity,
participants are more likely to
indulge with not quickly and in a
hurry due to the new physical
condition. Seeing from the impact
that occurs after post amputation
makes participants not free and free,
Not like before amputation or as
usual.
All activities are done rather slowly,
unlike before in amputation yes
rather quickly (P1)
There are only activities, but
activities that are not heavy (P4)
3
In this theme all participants
disclosed can researchers conclude
with the occurrence of amputations
in the body of participants will affect
the physical condition such as
weakness of the body, physical
conditions will affect the activity or
daily activity of a person. As a result,
the family as a person gets caught by
the participants gives aid in the
blessing. It is expected that patients
with amputation require help from
the surrounding environment in their
daily activities.
Experiencing role change (sub-theme
1.2)
According to participant experience,
role change occurs in participants
who have amputation. Role changes
such as job loss occur in the
following participants.
My son, told me not to work
anymore (P4)
Work is an activity or routine that
gives impact to one's material. Loss
of work is also experienced by the
following participants:
cannot do anything, cannot work to
make money for family(P1)
After the incident finally after the
series I feel the consequences all
because more or less cannot work
(P3)
Everyone has different reactions to
the threat of amputation. Behavior
and emotional depend on the nature
of the amputation, the participant's
attitude to the new condition. The
family is the person closest to the

participants, so that the effect is
immense to the participants'
emotional. Some participants who
used to be head of the family and
also as breadwinners now experience
role disorder. This role disruption
occurs because of the impact caused
to the new conditions experienced.
Yes, just stay at home (P1).
Participants in the study also
revealed that role change was also
identified in family function
changes, which should be the most
dominant income earner in the
family now changing into other
family members such as wives who
make a living for the family. This is
expressed by the following
participants.
My wife makes a cake order for
catering (P3).
In this theme participants experience
a change in the role of both the loss
of occupation and role disorder as a
functional unit structure within the
family. Participants mostly stopped
completely their work routines
because of conditions that were not
possible to move, some participants
also switched roles from previous
roles in the household.
Experiencing the grieving process
(sub-theme 1.3)
The grieving response is a response
indicated by the participant who has
been amputated. Participants in this
study showed reactions in the form
of disbelief he will be amputated,
surprise, bargaining, sadness, and
accept. Participants in this study
showed the attitude of not believing
4
that he was decided to do
amputation. Participants' statements
about their disbelief in the
amputation decision were expressed
by the following participants.
First of all I do not agree, if this
disease can be treated normally (P1)
Oh God my God, if can avoid is
very hurt (P2).
The participant response when it was
decided to do an amputation showed
a shocked reaction. This statement is
disclosed by the following
participants:
The first time the amputation was
decided, I was surprised (P1).
Bargaining has been described by the
insertion as a form of distrust.
The participant who expressed his
disbelief attempted to clarify what
was indicated by a bargaining
reaction through a sense of regret.
Participants in the diagnosis of
amputation will experience regret.
The participant's statement of
remorse is expressed by the
following participants:
If can this disease just treated
casually (P1).
Sense of regret is also experienced
by the following participants as a
consequence of the amputation
decision that has been lived.
Well, it turns out the remaining two
just the rest of my finger(P2).
Signs and symptoms of depression
are described by participants as a

form of protest against the
occurrence of amputation.
Participants in this study showed sad
behavior that causes depression
when it is amputated. The sadness
faced by participants in dealing with
the problem as one form of grieving
response to the loss of limbs it has.
Participants who experienced an
amputation showed feelings of worry
about the condition after it because it
was not able to work again and
impact on his life. The participant's
statements about her feelings of
worry about her illness are expressed
by the following participants.
I'm afraid, this fate of mine (P1).
Well, I keep also my mind this so as
not tired, which can cause blood
sugar to rise (P2).
Almost all participants express their
sadness, they think the impact that
will definitely be very influential that
is mainly on their role in the family.
Participants' statements about deep
feelings of sadness toward the
amputation decision are expressed by
the following participants.
Feeling sad there is also, gloomy at
home (P1).
Yes I am so sad, even time i cry
(P2).
In addition to reject the amputation
decision, another response that the
participant who was declared by
amputation was responding by
accepting the reality. Participants
express acceptance of the state of
amputation through the following
expression.
5
If it has rotted, just cut already
(P3).
On this theme all participants
disclose can researchers conclude
that in the grieving process there are
phases to be passed. Through this
stage then formed the acceptance
participants condition that have
experienced.
Various coping patients DM post
amputation (Theme2).
Participants who experience
amputation is a new chapter in his
life, the various stages through which
he can accept his new condition. In
the stage there is a process or way
that is done to solve the problem.
Various coping patients like more
worship, accept the situation, strong
motivation and seek social support.
The following is the researcher's
description of the sub themes found
in this theme.
More worship (sub-theme 2.1)
Some of the following participants
express a much prayer response to
God over what happened to him.
Conducting worship is demonstrated
by behaviors such as the time to pray
more, seeking clues about the truth
and drawing closer to God becoming
more intensive than before their
amputation. This is expressed by the
participants through the following
statement:
One of them by drawing closer to
God my confidence more and more
day (P1).
Just pray for the best(P2).

Some participants also express their
submissive attitude to God,
indicating acceptance of the new
condition he experienced as a
consequence of God. Participants
express feelings of resignation about
the state of amputation.
Resigned to accept the
circumstances, maybe this has
become the destiny of god (P1).
But I just accept the fact (P2).
Gratefulness is also expressed by a
participant below. Gratitude is
encouraged because of the remaining
organs that survived the amputation,
this makes gratitude.
"Ehmm, how did you feel? Feeling
good already, I has seen my friend
his legs already gone, thank God I
still have 2 finger (P1).
A participant expresses his
gratefulness to God for his new
condition, because the participants
believe this is the way of God to
make the problem solved.
"I am even thankful to God ..." (P3).
Accept the circumstances (sub-theme
2.2)
The various stages of the process that
participants go through to the stage
of acceptance of new conditions is
not easy. Gaining a lot of support and
receiving sympathy from others is
one form of the process of receiving
to face new conditions. This is
expressed by the participants through
the following statement:
When at the office, encouraged
6
friends, yesterday at the hospital
treated many who come for visit, he
wish better than now (P2) .
When the amputation conditions, the
family tried adapt in large changes
due to change in body condition in
one these families. The attention
given by the family to the
participants is a form of
encouragement in facing their new
condition. This is expressed by
participants through the following
expression:
Hope God always protects you,
said you still given a chance by
Allah (P4).
Receiving attention is also obtained
from the following participants as a
given expression. Sympathetic form
new condition that happened. The
sympathetic reception of others is
one part in order to accept his new
state.
I do not worry, he said, maybe
because of my condition like this
they are also sorry (P1).
Strong motivation (sub-theme 2.3)
Everyone always uses coping, either
adaptive or maladaptive to be able to
adapt. The motivation to recover and
motivation to return to normal
conditions is some form of
motivation revealed by some of the
following participants.
Disease had medicine hope soon
recover, yes until now (P2).
Participants have the ability to adapt
to new circumstances, showing a
good response by expressing realistic

expectations of their circumstances
with expectations of return to normal
conditions. This is expressed by the
participants through the following
statement.
I still show that I am capable like
most people (P1)
Expectations expressed by the
participants above is one of the ways
of solving the problems faced related
to the process of receiving the new
condition.
Seeking social support (sub-theme
2.4)
Support as a form of coping received
by participants. Material support and
support information is identified
within this sub-theme. Here are some
related social support statements
received.
Brothers and sisters, they says "bro
get some other skill" (P1).
In addition to the need to feel secure,
patients with amputees identify the
need for information as a high
priority. The need for what step
process will be lived in the future at
that time. They also need to know
how the process going forward. This
is expressed by participants through
the following expression:
Spirit and ask to friends (P2).
In addition to moral support, partipan
in this study revealed that there are
parties who provide assistance in the
form of material or cost. Participants
revealed that there were families
with good attention. This is
7
expressed by participants through the
following expression.
This stick was given yesterday by
the result of fundraising from my
family, my family is kind to
me(P1).
We already spend money about
million, outside of personal(P2).
So my fee at mulya sari hospital is
almost "20 million is borne by all
companies (P3).
So said my son-in-law all of them, I
do not think about the cost, which I
think only health (P4).
Social support received is one form
of environmental response around
the sense of want to help to
participants who underwent new
conditions. The problems faced by
participants when starting new life
conditions create external responses
that can help in the coping process
that will do.
4. Discussion
Participants who experience the state
of amputation will feel the impacts in
life. The impact is felt directly by
participants such as experiencing
obstacles in the activity, changing the
role, and experience the process of
grieving. Almost all participants in
this study had a similar experience of
perceived physical complaints of
inability to indulge independently,
due to changes in new physical
conditions experienced. Amputation
affects men and women of all ages,
classes, races and religions. The
reactions / responses of each
participant are unique and diverse.
This finding is similar to that found

by Sebaee & Mohamed (2011) that
amputation poses challenges at
various levels such as impact on the
physical aspect.
Findings of disturbance in the
activity also identified in this study
indicated by the inability of
participants in daily activities should
be assisted with others such as close
family of children, husband / wife
and even close relatives. The phrase
activity is done rather slowly also
identified this study, the activities
performed are not as fast and the
previous one before amputation.
These findings are supported by
research conducted by Helena
Burger (2012) found 36 subject,
those who have amputated have
impaired body functions and barriers
in the activity. A similar study
conducted by Nur Widayati (2015) in
his research resulted in several
obstacles and coping strategies in
managing self-care for diabetics,
namely physical barriers,
psychological barriers, and
knowledge barriers.
Subsequent findings in this study
found a role change in participants
who experienced amputation. These
role changes occur in job loss and
role disorder. Participants in the
study revealed that the participants
were silent at home and did not work
anymore. This suggests that
amputation conditions will have an
impact on the loss of primary
employment as income for the
family. The role change in the family
function, as it should be the father as
the most dominant family backbone
will be assisted by the wife in
seeking income for the family's live
8
hood.
This is the impact of the new
conditions it receives, patients with
amputation have limitations. The
limitations experienced will have an
impact in the work and activities in
everyday life. The role disorder is
the inability of a person to carry out
his duties in full, and be replaced by
others. The family is part of society
and plays a role in the life of
someone who lives his new life
especially with the condition of
amputation. Family empowerment
affects the coping of participants
who are experiencing problems, it is
found in Iwan Adrian (2013) study
that family empowerment
significantly influence family coping
in families with DM patients. The
opinion is in line with the results of
research conducted by Achmad
Khalif (2014) found the theme of one
of the necessary support including
family support. The results of this
study are in line with existing
research that family support is
necessary for participants who
undergo activities with all the
limitations.
Further findings of the grieving
process were also found in this study.
There was a diversity of responses
when participants were diagnosed
with amputation. The attitude shown
by participants who mourn the
diagnosis of amputation is to deny,
surprise, bargain, sadness, and
accept.
Rejection will be done amputation
process almost experienced by all
participants in this research. This
rejection process is in the form of

disapproval of the action to be
performed. When participants know
that they are suffering from a
disease, they will feel a change and a
loss. The findings of Kozier, Erb,
Berman and Snyder (2011) found
that loss is an actual and potential
situation in which something of
value is worth changing, no longer
present or disappearing.
For most people DM disease is a
very worrying disease and people are
aware of the impact that may arise.
Many people die due to
complications. According to Kubler
Ross (1969) in Suliswati et al. (2005)
the first reaction of the losing
participants was shocking,
unbelieving, feeling stricken and
denying.
The existence of a bargaining
process by participants diagnosed to
be amputated was first identified in
the response refused in this study.
The emergence of denying feelings
expressed by participants in peroses
is caused due to illness suffered
today. Participants are wondering
whether they are still able to work
and work in the current state of
illness. It is an effort performed by
participants as an expression in
showing perasaaanya. The process of
bargaining is in accordance with the
opinion suliswati et al. (2005), if the
participant has been able to express
his anger, then he will advance at the
bargaining stage. Seek to bargain to
avoid losing, expressing guilt or fear
problems.
The results of this study are in
accordance with the findings that if
participants have been able to
9
express their anger, then he will
advance in the bargaining phase, the
reaction of feelings of guilt and
anger. It is a sensitive phase so easily
offended. It is a coping participant to
cover up the feelings of
disappointment and is an anxiety
manifestation of the diagnosis of the
illness experienced.
The study also found a deep sadness
associated with the condition
experienced. Non-verbal behavior is
shown by participants such as head
bowed, moody faces and even
crying. Deep sadness is generally not
only felt in patients with amputation
caused by diabetes mellitus. Anxiety
will afflict almost everyone at any
given time in his or her life which is
a normal reaction to a life-
threatening or threatening situation.
The study's findings by Vladimira
Fejfarova et al. (2014) in most
diabetes mellitus patients, especially
those with DF (Diabetic foot) with
the risk of amputation having
uncontrolled stress well. The
findings are in accordance with the
results of this study that participants
expressed anxiety.
Against the conditions experienced.
The anxiety that participants
experience arises as a result of the
consequences of amputation. A study
by Hanan (2011) found that patients
with an amputated limb will face
stress related to their new condition.
The number of influences or impacts
if no amputation takes place allows
participants to be shocked by the
condition if not amputated. The
findings of Daniella Margalit, Eyal
Heled, Corinne Barger (2013) found

that those who reject the
consequences of amputation will
experience severity. This makes
amputation an act that participants
must accept as a way to avoid
severity of their condition.
Some of the results of research that
related with receive response shows
the same results found by the
researcher is when participants feel
surprised, anxious and sad. The
existence of this similarity because is
a natural response that occurs during
the process of changes in health
conditions that occur in participants.
Acceptance is the final phase of the
loss process, in which one develops a
sense of peace, accepts destiny. The
deep feelings of sadness and physical
pain experienced by participants may
be lost in this phase. Kuber-Ross
describes this fifth phase as the end
of the struggle in the process of loss.
The results of this study have
similarities with the theory of Kubler
Ross, at the acceptance stage
participants realize that life must
continue and they must seek new
meaning from the current state.
Participants have accepted the reality
of their loss. Participants at this stage
begin to draw up a plan that will be
done in addressing the condition.
This is due to the emergence of
coping strategies in participants who
are diagnosed with the disease.
Participants involve various attempts
to regulate their emotions and adjust
to the effects of the situation.
The next theme in this study is the
various copies found in this study
including: more worshiping,
accepting circumstances, having
10
realistic expectations, and seeking
social support.
The second finding in this research is
the identified spiritual activity that
the participants behaved in
performing the worship during the
sick by praying a lot to God.
Participants believe with a lot of
prayer will help the recovery
process. Participants at the time of
illness become less able to care for
themselves and rely on others in their
care and support. Spiritual distress
can develop in line with someone
searching for meaning what
happened, which may lead to a
person feeling alone and isolated
from others. Research findings by
Mattias Anderson (2006) that a lot of
worship is one of the adaptive coping
response in the form approach to
God.
Clients with a spiritual belief can feel
that their beliefs are challenged by
their health situation. The findings of
Kozier et al., 2011 in its findings find
the fulfillment of spirituality needs to
improve coping and expand the vital
resources available to clients. This is
also supported by the results of
research Abernety (2000) revealed
that the spiritual approach can reduce
stress and depression significantly.
This will improve the immune
response through the release of stress
hormones. A person's spiritual
strength can be an important factor in
the face of the changes caused by
chronic panyakit. Success in dealing
with changes caused by chronic
illness can strengthen a person in a
spiritual way.
The findings of Perry & Potter

(2005) in his research find those who
are spiritually strong will reshape
their identity and live in their
potential. The research is supported
by a study by Sudarma (2008) that is
for a person who is religious, healthy
or sick is believed to be from God's
behavior to His servant and ill is due
to God's destiny and only God who
has healing ability. The beliefs of the
participants, can increase the spirit of
a more optimistic life
Spiritual care encompasses the reach
of a person in the touch of the Divine
through sensing His presence,
praying, reading spiritual reading,
reciting.
There is a correspondence between
the results of this study with previous
research that participant in this study
reveals his experience in the aspect
of spirituality when sick or treated is
a lot of praying. Prayer is believed to
heal the sick and pave the way for
those who are in a state of
helplessness and can be a source of
comfort and strength for believers.
Subsequent findings in this research
that participant get a lot of support
coming from family, peers, and the
surrounding community. Participant
support in the form of motivation
spirit, prayer, and feel sorry to be
identified in this study. Almost
everyone cannot solve their own
problems, but they need the help of
others. Based on the results of this
study that support was important
mediator in solving a person's
problem.
The relationship of good and long-
standing attachment Pratiwi's (2009)
11
study that social attachment and long
lasting relationships are accepted as
an emotional aspect of life. This can
stop the stress effect, help people
face stressful events and the
possibility of reducing stress due to
health conditions that apprehensive.
The study concludes that gaining
support and receiving sympathy from
others will influence the acceptance
of new conditions to be addressed.
Among the results of this study with
previous research, not all have
conformity. There are some
participants who express their
experience about the lack of concern
from the environment around their
living or work environment. The
environment acts as if it does not
know anything, does not pay
attention, even some are patronizing.
Participants in the study also
expressed their hope to return as
usual. This is a wish to heal and
return to normal. The results of this
study showed the ability to adapt by
participants who diagnosed
amputation as a coping done.
Roy (1984) sees people as adaptive
systems that function as wholeness
through the interdependence of their
parts. The system consists of input,
process control and output. Inputs
are stimuli from external and internal
environments, including information
from cognitive and regulatory
mechanisms. The process control
biological and pathological
mechanism of coping, as well
cognitive and regulatory response.
Output is an adaptive and ineffective
behavior response of a person.

Roy explains that the response that
leads to a decrease in body integrity
will lead to a need and cause the
participants to respond through
certain attempts or behaviors. Such
efforts are known as participants'
self-defense or coping mechanisms.
Every human being is always trying
to cope with changes in health status
and nurses must respond to help
humans adapt to these changes. As
human adaptive systems are depicted
in characteristic terms, so humans
are seen as a unity that is
interconnected between units as a
whole or a unit for multiple
purposes.
A study conducted by Hanan A EL
Sebae & Labiba A Mohamed (2011)
found that patients with an
amputated extremity were newly
exposed to different stresses related
to social life, work situations, and
body image changes.
The results of this study indicate that
there is a correspondence between
the participants' experience in the
process of adjustment or adaptation
to the disease suffered with relevant
research results. Participants
diagnosed with amputees have great
expectations in everything, such as
strong motivations such as longevity,
recovery from illness and staying
healthy, and hope for medication that
can help the healing process.
Participants show adaptive behavior
by trying to find.
Subsequent findings were found in
participants in the form of seeking
support. Every participant who is
hospitalized has limitations in
fulfilling all his needs. Family
12
support is needed in every treatment
performed on sick participants. The
results of this study identify the form
of family support provided to
patients in the form of information
support and support costs. Family is
small social systems covering a
series of interdependent and
influenced parts of both internal and
external structures. A person's
support can prevent the development
of problems due to the pressures
faced. A person with high support
will be more successful in dealing
with and overcoming his problems
than those who do not have support.
Support received from both family
and community was identified in this
study. Contributions on family
support in the Lestari report (2011)
shows the support of most
respondents in good category
(40.0%), followed by bad category
(32.0%) and last category (14.0%).
Family support consists of
informational support, instrumental
support, assessment support and
emotional support. The highest
family support is emotional support
(69.14%), whereas the least
informational support (59.00%).
The importance of support required
by participants in this study is one of
the coping strategies that participants
receive as an effort to lead to the
adaptation process. This is in line
with the research by Chanelle Grech,
Roberta Farrugia (2014) identifies
that there are various changes in
reactions that occur after the loss of
limbs found the importance of family
members and cyclical support as an
important part of the adaptation of
participants to their new condition.

Great family support to
psychologically ill participants can
add to the spirit of life that can
increase confidence in the process of
recurrence. This is supported by
findings in the study of Isabel Leal,
et al. (2011) reactions and feelings
about amputation conditions have
changed in their lives and received
social support.
The results of this study indicate that
the support received in the form of
information support and support
costs disclosed by participants. The
establishment of a good relationship
between family and sick family
members will support healing. A
good family knowledge of
amputations will affect his attitude in
the care of patients while at home.
The better the care done by the
family is expected to minimize the
severity.
5. Conclusions
Response to accept amputation
conditions will be experienced in
patients who have passed the
amputation stage, as the process goes
through such as the ability to adapt /
adapt themselves to new conditions
and support received. The process
that heavily affects the outcome of
the acceptance of his new condition,
it also determines the coping that is
formed in the patient, whether the
coping is adaptive or maladaptive.
Based on the findings of the
researchers all participants can cope
and remain on adaptive coping as a
process that is pursued to return to
normal life.
13
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