Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in Kwa-Zulu Natal
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An estimated 387 million people worldwide already have diabetes mellitus (DM), with those numbers rising to an estimated 592 million people by the year 2035. The prevalence of diabetes mellitus continues to increase with the largest increase seen in low- and middleincome countries, such as South Africa (Shaw, Sicree,& Zimmet, 2010; Peer et al., 2012; International Diabetes Federation, 2014; Bertram et al., 2013; Mayosi et al., 2009). Lowerlimb amputation is a common complication of uncontrolled diabetes mellitus (Moxey et al., 2011) and there is a marked increase in the incidence of diabetes mellitus in rural areas in South Africa. The impact that the amputation has on the individual's life can be devastating since the amputation of the limb is likely to be accompanied by a profound sense of loss. Rehabilitation can assist to retrain physical and functional abilities, psychological and emotional adjustment issues, as well as social and community reintegration (Manderson & Warren, 2010). Therefore, comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Persons with disabilities who live in rural areas experience challenges accessing health services and rehabilitation (Harris et al., 2011). Even though challenges with accessing healthcare in rural settings are well documented, there is no literature specifically pertaining to persons with lower-limb amputations in a rural South African context.