Assessment of Quality of Life of Patients with Diabetic Ulcers by Cardiff Wound Impact Schedule (CWIS)

Abstract

Diabetic ulcers have a negative impact on quality of life (QoL). The purpose of the study was to assess QoL of patients with diabetic ulcers. This was a cross-sectional study or diabetic leg and foot ulcer patients (n=301) admitted to the National Hospital of Sri Lanka. QoL was assessed using condition specific Cardiff Wound Impact Schedule (CWIS) validated for Sri Lanka. CWIS comprises of three subscales; social life (SL), well-being (WB) and physical symptoms and daily living (PSDL). Scores are calculated for each domain (0-100) and scores of subscales are summed up as total QoL. High score in CWIS denotes high QoL. Mean age of patients was 59.26 (SD±9.4) years. 56% (n=169) of patients were females. Mean scores of total QoL (162.22/300), and all sub scales, SL (58.45/100), WB (43.29/100), and PSDL (60.0/100) of the study population were low. QoL (mean) of women was lower than men in total QoL (157.04 vs. 168.85, p=0.028) and subscale of WB (40.99 vs. 46.23, p=0.011). Total QoL among three groups; retired, presently employed and unemployed were significantly different (p=0.008) with lowest scores among those unemployed. Scores of total QoL (p=0.004), subscales of SL (p=0.004) and WB (p=O.O13) were significantly lower in those depending on others than those living on their own. QoL was low in those with ulcer experience of <6 weeks duration, in total QoL (p=0.019), subscales of PSDL (p=0.043), and WB (p=0.005). No significant differences were observed with patients' age, educational level and the site of ulcer. QoL measured using CWIS is low in patients with diabetic leg and foot ulcers. Better QoL was found in men than women. QoL is lowest in the unemployed group. Patients living on their own have better QoL than those who depend on others. QoL was not affected by the site of the ulcer. Initial stages of ulcer experience were associated with lower QoL than having an ulcer for a long duration. This study showed that female gender, unemployment, dependence to others and the initial stages of ulcer were associated with poor QoL. These factors should be considered when managing patients with diabetic ulcers