The impact of diabetic foot ulceration on the psychosocial life of individuals living with diabetes

Abstract

Background: The development of a diabetic Foot Ulcer (DFU) is a serious complication of diabetes mellitus which has great impact on the quality of life (QoL), including the psychological aspect, of patients living with diabetes leading to poorer health outcomes. While both the chronicity of diabetes itself and the burden of DFU have an impact on the individuals QOL the specific impact of DFU is still unclear. This study therefore aimed to investigate the impact of diabetic foot ulcers on the QoL in patients living with diabetes among Maltese population. Aim: To investigate the impact of DFUs on the psychosocial aspect and assess their effect on the QoL of patients living with diabetes among Maltese population. Design & Methods: A quantitative non-experimental study was conducted to investigate the impact of DFUs on the QoL, including psychosocial aspect, in individuals living with diabetes in Malta. Data was collected between November 2021 to February 2022 in Diabetic foot clinic, Diabetic foot ward and Tissue viability unit in the national hospital (Mater Dei Hospital). Two questionnaires were administered to assess QoL; Group A (n=24) was given DFS and WHOQOL-BREF, Group B (n=28) was given WHOQOL-BREF. Results: Fifty-two participants were recruited for the study. These included participants living with DFUs (Group A, n=24) and participants living with DM but without DFUs (group B, n=28) aged ³18 years. Group B had higher mean subscale scores in WHOQOL-BREF however, the difference was marginal between both groups and did not reach statistical significance. The highest mean score for Group A was in social domain, followed by environment domain, then psychological domain while the lowest was in physical domain. Furthermore, DFS showed that Group A participants had lowest score in emotional domain whereas highest score in satisfaction domain. Conclusion: Poor QoL in all participants is indicative of the negative impact that can be caused by diabetes itself. The psychosocial impact of diabetes is indicated by lower scores in the emotional and psychological domains in both groups. Although this study showed lower scores of QoL in patients with DFUs compared to patients without DFUs the difference was not statistically significant. The low scores in the psychosocial aspect of QoL in patients living with diabetes therefore suggests the need for regular screening of physical, emotional and psychological well being as it is important to improve health outcomes and to potentially prevent life-threatening complications.