Health Related Quality of Life of Patients with Diabetic Leg and Foot Ulcers

Abstract

Diabetic leg and foot ulcers are shown to have a negative impact on health related quality of life (HRQoL). The purpose of this study was to evaluate HRQoL of patients with diabetic leg and foot ulcers and to examine associations between HRQoL and socio demographic and clinical characteristics. In this cross- sectional study, adult diabetic leg and foot ulcer patients admitted to the surgical wards were included. The demographic and clinical characteristics were recorded and HRQoL was evaluated using Short Form 36 (SF-36) survey for all the patients. Eight domains of SF-36 (total HRQoL score), physical component score (PCS) and mental component score (MCS) were measured and associations were determined with patients' characteristics. From the total of 140 patients, 51% (n=71) were males. Mean age and duration of diabetes mellitus were 58.14±10 and 9.5±7.2 years respectively. High proportion of patients (n=113) had foot ulcers. Retinopathy and poor vision, hypertension, and neuropathy were seen in 52 (36.7%), 48 (34.3%) and 52 (37 %) patients respectively. The total HRQoL score was 46.46 ± 18.45. PCS (41.48± 19.05) and MCS (51.53± 19.9) scores were also low. HRQoL of women was lower than men in total score (p=0.014), MCS (p=O.022), and PCS (p=O.013). Total, PCSand MCS scores were significantly lower in the patients with retinopathy and poor vision, and hypertension (p= 0.02-p <0.0001) than the patients with normal vision and normotensives. Unemployment and presence of diabetic leg ulcers were associated with poor HRQoL. No association was seen with the patients' age, educational level and whether patients live on their own. In conclusion, diabetic leg and foot ulcers have a negative impact on HRQoL with both physical and mental health being affected. Female gender, unemployment, presence of retinopathy and low vision, hypertension and ulcer site being the leg were the factors associated with poor HRQoL.