Feelings of powerlessness in those with diabetic foot ulcers.

NewsBot · Jun 12, 2025

The impact of depression on healing outcomes in people with diabetes-related foot ulcers: A systematic review
Abeer M Al-Smadi et al
Diabetes Res Clin Pract. 2025 Jul:225:112275

This systematic review examined the impact of depression on healing outcomes among people with diabetes-related foot ulcers (DFUs). A comprehensive search of MEDLINE, APA PsycINFO, CINAHL, Embase, and The Cochrane Library was conducted from inception (1976) to 11 March 2024 to identify eligible studies. The Mixed Methods Appraisal Tool (MMAT) was used to assess study quality, and a narrative synthesis was conducted. We identified 1403 articles, of which 11 were included in the final analysis and included a total of 1392 participants with DFUs. The included studies used diagnostic interviews and screening tools to assess depression, and healing outcomes were described as healed ulcer, change in ulcer size, and/or changes in ulcer severity classification tool scores. Of the 11 studies, five studies (45.5 %) found that there was a significant negative impact (or association) of depression on healing outcomes of DFUs. On the other hand, six studies (54.5 %) showed there was no significant impact or association. Three studies were considered high quality, four studies medium quality, and four studies low quality. Depression may have a significant negative impact on healing outcomes in people with DFUs. However, the existing evidence is still unclear, and further high-quality studies are needed to investigate this impact.
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NewsBot · Jul 19, 2025

"It is a constant battle": A qualitative study of the lived experience of individuals with diabetic foot ulcer and post-healing challenges in primary care
Xiaoli Zhu et al
Diabet Med. 2025 Jul 17:e70096.

Aim: To explore the lived experiences of primary care patients with active diabetic foot ulcer (DFU) and post-healing in remission (PHIR) to inform tailored interventions.

Methods: A qualitative interview study was conducted with primary care patients with DFU and PHIR in Singapore. In-depth interviews were held with 27 participants (15 with active DFU and 12 with PHIR) from April to July 2022. Transcripts were analysed using thematic analysis.

Results: The lived experiences of individuals with DFU across its stages (active DFU and PHIR) were encapsulated in the notion of 'a cyclical lifelong illness threat alongside a vicious foot cycle', reflected in three key themes. The first theme, Making Sense of DFU, captured participants' varied perceptions of their condition-from misattributing in DFU management to seeing it as a constant battle, an unavoidable terminal disease (active DFU) or a wake-up call (PHIR). The second theme, Emotional Consequences, highlighted the significant psychological burden experienced by participants, encompassing emotional exhaustion leading to self care burnout, as well as chronic anxiety and persistent fear of recurrence. The third theme, Behavioural Challenges, illustrated the complexities of self management, with participants describing their efforts as a constant struggle to maintain self care routines, often marked by ambivalence towards long-term adherence.

Conclusions: This study highlights the persistent psychosocial and behavioural challenges faced by individuals with DFU and PHIR, underscoring the need for autonomy-supportive and empowerment-focused interventions to reshape perceptions of DFU, alleviate emotional distress and enhance adherence to self care.
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NewsBot · Aug 3, 2025

Understanding Diabetes-Related Extremity Amputation Depression & Distress (DREADD)

NewsBot · Aug 13, 2025

Interviews with patients with diabetic foot ulcers in Sweden reveal heavy burdens of constant vigilance and fear
Anneli Ringblom et al
J Wound Care. 2025 Aug 2;34(8):600-607.

Objective: To investigate the experiences of everyday life of patients with diabetic foot ulcers (DFUs) in Sweden.

Method: Semi-structured interviews were conducted from 2021-2022 with patients with active DFUs. The results were subjected to qualitative content analysis.

Results: Participants included 15 male patients and five female patients (mean age: 68 years). Responses revealed that patients felt that they had to be constantly vigilant to reduce the risk of developing a DFU. Ignoring a subtle sign could lead to disaster, i.e., amputation of the foot. This imposed a heavy burden on the patients. They also expressed sorrow over being unable to engage in cherished habits, such as swimming or walking barefoot. Some felt that doctors lacked interest in their feet, as compared with more 'prestigious' organs, such as the heart and kidneys, and they wished that they had received more information at an early stage of the disease. Pain was a significant problem for some individuals, and they did not receive adequate pain medication.

Conclusion: Despite accessible and cost-free care of DFUs in Sweden, these wounds exert profound negative impacts on patient wellbeing, not least because patients assume responsibility for avoiding worsening of their condition. Therefore, it is important for clinicians to acknowledge the patient's resources, needs and concerns, and, together with the patient, devise care goals that are realistic and achievable for both the patient and clinicians.
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NewsBot · Aug 17, 2025

The Relationship Wound Grade and Neuropathy Status With
Anxiety in Diabetic Foot Wound Patients
Hanafi Hanafi et al
Journal Of Community Development and Disaster Management

Background. Microvascular complications in diabetes mellitus patients often
occur in the eyes (diabetic retinopathy) and diabetic neuropathy which will
cause numbness in the extremities, while macrovascular complications can
occur in coronary artery blood vessels in the heart, disorders of large blood
vessels in the feet which will increase the risk of necrosis in the extremities
Objective. The purpose of this study was to determine whether the
relationship between Wound Grade and Neuropathy Status to the level of
anxiety in patients with diabetic foot wounds Method. This type of research
is descriptive analytical with a cross-sectional approach. Cross-sectional
research with a sample size of 30, the sampling technique used by researchers
was purposive sampling, the instruments in this study were observation
sheets and Anxiety Inventory (S-AI) Form y Results. The results of the study
obtained that there was no relationship between wound grade and anxiety
levels in patients with diabetic foot wounds p-value 0.691> 0.05 and there was
no relationship between neuropathy status and anxiety levels in patients with
diabetic foot wounds p-value 0.248> 0.05 Conclusion. There was no
correlation between wound grade and neuropathy status and anxiety levels in
patients with diabetic foot ulcers
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NewsBot · Aug 23, 2025

Psychological Well-Being and Coping Strategies Among Patients With
Diabetic Foot Ulcer: A Correlative Study
Vijayalaxmi, Hezil Reema Barboza
Source

Objectives: A diabetic foot ulcer (DFU) is a most typical complication of diabetes mellitus that occurs due to poor glycaemic control, improper foot
care, and dry skin. Well-being may be adversely affected by non-healing wounds. Inadequate coping strategies lead to adverse effects. The objective of
this study is to evaluate the correlation between psychological well-being and coping strategies among patients with DFU.
Material and Methods: A non-experimental correlative study was conducted among patients (n=90) with DFU in a selected hospital in Karnataka.
Patients were selected purposively based on inclusion and exclusion criteria. Data was collected using a psychological general well-being scale and brief
COPE questionnaire.
Results: The findings of the study revealed that 43 (47.8%) participants showed strong distress. There was a negative correlation of psychological well-being with problem-focused coping (r=- 0.22, p=0.03) and avoidant-focused coping (r=- 0.34, p=0.01). There was a significant association between psychological well-being and age (p=0.022) and monthly income (p=0.03). Emotional coping strategies were associated with the type of family (p=0.006),
and avoidant coping strategies were associated with the age of the patients (p=0.021).
Conclusion: This study showed that patients with diabetic feet were in strong distress. A negative correlation existed between psychological well-being
and coping strategies such as problem-focused coping and avoidant-focused coping. The study highlights the need for behavioural therapies regarding
the adaptation of coping strategies to manage their actions and emotions
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NewsBot · Oct 29, 2025

The Design Of A Psycho-Socioeconomic
Biobehavioural Framework To Address
Barriers To Adherence In Patients With
Diabetes-Related Foot Ulceration
Jonathan Brocklehurst MSc MIRL MRCPod
Source

Abstract: Diabetes mellitus is a chronic metabolic condition.1 Related comorbidities such as peripheral
neuropathy and lower extremity ischaemia can significantly increase the likelihood of the occurrence of
a diabetes-related foot ulcer (DFU). The International Working Group on the Diabetic Foot (IWGDF)
updated its latest guidelines in 2023 to address diabetes-related foot care across the world and champion lower
limb preservation. 2,3 Further, with a podiatry workforce ‘in crisis’ in the United Kingdom and elsewhere,
understanding the experiences of patients is important in establishing ways to provide and implement effective
self-care regimes for patients in both private and public health practice.4,5 Therefore, psycho-socioeconomic
bio-behavioural barriers (PSB) are important in forming holistic considerations of patient adherence. 6 The
Biopsychosocial Model (Engel 1977) and The Health Belief Model (Rosenstock 1988) provide an initial
foundation for expansion on these themes. 8,9 The PSB framework is a novel concept which leverages these
theories and suggests that motivational interviewing could serve as an initial psychological intervention
to filter the key barriers to adherence in patients with a DFU.10 This conceptual framework allows for the
proposal of tailored multi-disciplinary interventions, such as accessible educational programs, to address
specific barriers to adherence with the objective of contributing to lower limb preservation.11-13
Key words: diabetes mellitus, diabetic foot ulcer, podiatry, adherence, self-care, psycho-socioeconomic bio-
behavioural barriers
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NewsBot · Nov 7, 2025

A Qualitative Study of Follow-Up Needs in Patients With Diabetic Foot Ulcers Based on the Biopsychosocial Model
Ting Li et al
Source

Aim: The aim of this study was to explore the follow-up needs of patients with diabetic foot ulcers.

Design: A qualitative descriptive study was conducted, guided by Engel's biopsychosocial model.

Methods: Purposive sampling was used to recruit 17 patients with diabetic foot ulcers of Wagner grade ≥ 1. These patients had received care in the Endocrinology and Metabolism Department or the Wound Clinic of a tertiary hospital in Xi'an, China. Guided by the biopsychosocial model, individual face-to-face semi-structured interviews were conducted between April and July 2024. Data were analysed using thematic analysis.

Results: Nine themes were identified. In the biological domain, patients reported needs for disease care and lifestyle modification. In the psychological domain, they highlighted the importance of emotional coping support and building trust with healthcare providers. In the social domain, patients expressed needs for personalised follow-up, equitable access to healthcare, financial support, community assistance, and management of family caregiving role conflicts.

Conclusions: This study identified biological, psychological, and social follow-up needs among patients with diabetic foot ulcers, highlighting the importance of holistic follow-up to promote recovery and improve quality of life after discharge.

Implications for the profession: Nurses should assess and address the biological, psychological, and social follow-up needs of patients with diabetic foot ulcers after discharge, providing tailored care to promote ulcer healing and prevent recurrence.
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NewsBot · Mar 10, 2026

Impact of social and psychological factors on foot self-care in diabetic foot patients: Based on variable-centered and individual-centered analysis
Wenyan Xu et al
J Tissue Viability. 2026 Mar 6;35(2):100991.

Background: Diabetic foot (DF) is a serious diabetes complication that increases ulceration, amputation and mortality risks. Effective foot self-care can prevent up to 85% of ulcer events. This study aimed to assess foot self-care behaviors among middle-aged and older DF patients, evaluate the impact of social support, and explore the mediating effects of frailty and fear of progression (FoP). We also identified patient subtypes using latent profile analysis.

Methods: A cross-sectional study was conducted in a tertiary hospital from November 2024 to March 2025. A total of 361 patients with DF aged ≥45 years completed validated questionnaires, including the Social Support Rating Scale (SSRS), FRAIL Scale, FoP-Q-SF, and DFSQ-UMA. Structural equation modeling (SEM) assessed mediation effects, and latent profile analysis (LPA) identified subgroups based on frailty and FoP.

Results: A total of 383 questionnaires were distributed, with 361 valid responses collected, resulting in an effective response rate of 94.3%. The average score for foot self-care behavior was 58.52 ± 13.46, while levels of social support, frailty, and FoP were all at moderate levels. SEM indicated that Social support significantly predicted better foot self-care behavior (β = 0.225, P < 0.01). Frailty and FoP partially mediated this relationship (mediation effect: 6.68%). LPA identified three types of physical and mental profiles: Low FoP - Low Frailty Group (75.1%), Moderate FoP - Moderate Frailty Group (15.2%), and High FoP - High Frailty Group (9.7%). Importantly, patients in the High FoP-High Frailty Group demonstrated the lowest foot self-care behavior (mean = 43.70, P < 0.001), indicating the highest potential risk for ulcer occurrence and poor tissue outcomes.

Conclusion: Social support enhances foot self-care in DF patients through reduced Frailty and FoP. Tailored interventions targeting high-risk subgroups may improve tissue outcomes and prevent ulcers.
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Feelings of powerlessness in those with diabetic foot ulcers.

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Nurses' and patients' feelings of disgust associated with malodorous wounds

Aerobic exericse for feelings of persistent fatigue

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Feelings of powerlessness in those with diabetic foot ulcers.

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Nurses' and patients' feelings of disgust associated with malodorous wounds

Aerobic exericse for feelings of persistent fatigue

Share This Page

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