Abstract
<title>Abstract</title> <p>Background Diabetic foot-related amputation affects physical, psychological, and social functioning, but patients’ decision-making barriers and support needs remain unclear. Objective To explore decision-making experiences and support needs among patients undergoing diabetic foot-related amputation and develop a patient journey map. Methods This descriptive longitudinal qualitative study was conducted in a tertiary hospital in Nantong, China. Fifteen patients were recruited between December 2024 and July 2025 and followed until the 6-month postdischarge interview. Interviews were conducted at four time points. Data were analyzed using inductive content analysis. A patient journey map used clinical stage as the timeline and tasks, emotional responses, barriers, and support needs as analytic dimensions. Results Three stages were identified: symptom recognition and diagnostic screening, amputation treatment decision-making, and home rehabilitation and long-term self-management. Patients underestimated wound severity, delayed care seeking, and had limited access to specialized services. During amputation decision-making, they balanced limb salvage hopes against survival risk and reported difficulty understanding treatment information, poor communication, and limited participation. During rehabilitation, unmet needs involved self-care skills, body image changes, financial pressure, and continuity of care. Conclusion Decision-making experiences and support needs changed dynamically. Clinical teams should provide continuous, comprehensible, and preference-sensitive support during early risk recognition, amputation communication, and postdischarge self-management.</p>