Quality of life in those with diabetic foot ulcers

NewsBot · Sep 14, 2025

Patient-Reported Experience (PREMs) and Outcome (PROMs) Measures in Diabetic Foot Disease Management-A Scoping Review
Elisa Amato et al
J Clin Med. 2025 Aug 29;14(17):6116.

Background/Objectives: Diabetic foot syndrome (DFS) is a chronic complication of diabetes mellitus that negatively impacts patients' quality of life (QoL). Patients' perceptions of health status and healthcare can be assessed using Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs). This article aims to review the available literature on PREMs and PROMs, evaluate their characteristics, and determine whether an existing measure is applicable to or can be developed for the patient population of a third-level unit for diabetic foot. Methods: A search through Cinahl, Scopus, and Pubmed electronic databases was conducted to identify studies published between 2000 and 2024. Eligible studies included those using PREMs and PROMs in patients with DFS. Studies that used self-assessment methods or open questions and those that applied PROMs in people living with diabetes without diabetic foot were excluded. Results: After a careful selection, 53 studies met the inclusion criteria: none of these applied PREMs. Regarding PROMs, 46 studies applied a generic method alone or in combination with a specific tool to large populations comparing patient groups, while 7 studies applied a specific PROM alone to small populations evaluating specific aspects of pathology. Conclusions: In the existing literature, generic tools are mainly reported. No gold standard has yet been identified among all the tools considered for assessment of quality of life or patients' perceptions of their health. Further studies are needed to develop a reliable and specific PREM or PROM questionnaire for complex patients affected by DFS.
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NewsBot · Sep 14, 2025

Psychological determinants of Health-Related quality of life in primary care patients with diabetic foot ulcers: a cross-sectional study in Singapore
Xiaoli Zhu, Jiayi Weng, Eng Sing Lee, Frederick H F Chan, Phoebe XH Lim, Ling Jia Goh, Jacqueline Giovanna De Roza, Yee Chui Chen and Konstadina Griva
BJGP Open 10 September 2025; BJGPO.2025.0091. DOI: https://doi.org/10.3399/BJGPO.2025.0091

Background Diabetic foot ulcers (DFUs) significantly impair health-related quality of life (HRQoL). While clinical predictors are well established, the contribution of psychological factors, particularly in primary care, remains underexplored.

Aim To examine the sociodemographic, clinical, and psychological determinants of HRQoL in individuals with DFUs to inform development of psychologically informed interventions.

Design & Setting Cross-sectional study in primary care settings.

Method A total of 186 patients with DFUs completed validated measures, including psychological variables (eg, the Diabetes Distress Scale and Brief Illness Perception Questionnaire) and Wound-QoL, which assesses quality of life in Body, Psyche, and Everyday Life domains. Hierarchical multiple regression analyses evaluated the contribution of psychological variables to HRQoL.

Results Psychological burden dominated, with Psyche HRQoL impaired in 57% of participants (mean = 2.0), outpacing Everyday Life (38%; mean = 1.3) and Body domains (24%; mean = 0.8). In hierarchical models, psychological variables—together with sociodemographic and clinical factors—explained 31.4% of the variance in Body HRQoL, with interpersonal distress and threat perceptions emerging as significant predictors. A similar model accounted for 39.2% of the variance in Psyche HRQoL, with female gender, emotional burden, and threat perceptions as key predictors. Everyday Life HRQoL was significantly associated with HbA1c, independence in daily activities, emotional burden, and threat perceptions, with the full model explaining 40.9% of the variance.

Conclusion Psychological factors significantly contributed to reduced HRQoL in primary care patients with DFUs. Routine screening and targeted, psychologically informed support—particularly for women, those with poor glycaemic control, or limited functional independence—are essential to improve outcomes.
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NewsBot · Jan 4, 2026

The lived reality of diabetic foot ulcers: a systematic review and meta-synthesis on patients' experiences and coping for a high-quality life
Arman Erjaee et al
J Diabetes Metab Disord. 2025 Oct 16;24(2):236.

Background: Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus, leading to infection, amputation, and reduced quality of life. Beyond their clinical impact, DFUs impose psychological, social, and economic burdens on affected individuals. Despite extensive research on DFU prevention and management, the lived experiences of those suffering from DFUs remain underexplored. Understanding these experiences is essential for improving patient-centered interventions and holistic care approaches.

Methods: A systematic review and meta-synthesis of qualitative studies were conducted following PRISMA and ENTREQ guidelines. A comprehensive search was performed in PubMed, CINAHL, PsycINFO, Scopus, and Web of Science from 2020 to 2024. Studies were selected based on the SPIDER framework, focusing on adults with DFUs and their lived experiences. Noblit and Hare's meta-ethnographic approach was used to synthesize data, identifying first-, second-, and third-order constructs. Thematic synthesis was applied to extract key challenges, coping strategies, and resilience factors from the included studies.

Results: The analysis included 27 studies with 576 participants and identified four uplifting themes: (1) Rising Above Daily Challenges with DFUs, showing how people stay active, turn struggles into strengths, and care for their feet with pride; (2) Moving Forward Through Uncertainty and Connection, highlighting hope, teamwork with others, and efforts to find helpful information; (3) Embracing a New Way of Living, reflecting creative solutions, joy in fresh starts, and welcoming support; and (4) Growing Stronger with Purpose and Support, capturing personal growth and building encouraging relationships. These themes reveal the many ways participants shine through their experiences.

Conclusion: This meta-synthesis underscores the complex, multifaceted impact of DFUs beyond the physical wound, emphasizing the necessity of holistic, patient-centered care. Enhancing communication, addressing psychosocial challenges, and integrating support systems can improve outcomes and quality of life for DFU patients. Future research should focus on culturally tailored interventions and longitudinal studies to track resilience over time.
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NewsBot · Mar 9, 2026

Validity, Reliability and Responsiveness of Wound-QoL-14 Quality of Life Questionnaire in Patients With Diabetes Related Foot Ulcers
L Hitchman et al
Int Wound J. 2026 Mar;23(3):e70816.

Diabetes related foot ulcers (DFU) are associated with significant physical, psychological and social dysfunction. Measuring the impact of treatments on patients' overall well-being is vital to ensure care is holistic. This study aimed to validate the Wound-Qol-14 quality of life assessment tool in people with a DFU. A single centre longitudinal prospective validation study in people with DFUs was conducted. Wound-Qol-14, Diabetic Foot Ulcer Scale-Short Form (DFS-SF) and EuroQol 5 dimensions 5 levels (EQ-5D-5L) were completed by people with DFUs at baseline and 6 months. Wound-Qol-14 was repeated within 7 days of the first questionnaire. Correlation coefficients with a cut off of ≥ 0.7 were used to assess convergent validity, divergent validity and responsiveness to changes in DFU severity. Reliability was assessed using Cronbach's α. The study aimed to recruit 100 people. One hundred and seven people were recruited. The mean age was 62 (SD 13) years and 85 (79.4%) were male. The mean DFU duration was 30 (SD 83) days and the mean DFU area was 6.2 (SD 10.7) cm2. Convergent validity was demonstrated in all domains of Wound-Qol-14 and DFS-SF (r - 0.695 to -0.799) except burden/bothered about ulcer care domains (r = -0.443). There was moderate correlation between Wound-Qol-14 domains and EQ-5D-5L dimensions (r = 0.477-0.501). Cronbach's α ranged from 0.683 to 0.919 for the domains of Wound-Qol-14. Wound-Qol-14 was not responsive to changes in DFU severity (r = -0.291; 95% CI -0.501 to -0.048) but was responsive to healing status (healed 1.14 [IQR 0.86] vs. unhealed 1.86 [IQR 1.47]; p = 0.017). Wound-Qol-14 is a valid and reliable tool to measure disease-specific quality of life in people with DFUs. Further work is needed to refine the responsiveness. EQ-5D-5L should be used to measure generic quality of life in people with DFUs.
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NewsBot · Mar 15, 2026

Validity, Reliability and Responsiveness of Wound‐QoL‐14 Quality of Life Questionnaire in Patients With Diabetes Related Foot Ulcers
L Hitchman et al
Int Wound J. 2026 Mar 8;23(3):e70816. doi: 10.1111/iwj.70816

Diabetes related foot ulcers (DFU) are associated with significant physical, psychological and social dysfunction. Measuring the impact of treatments on patients' overall well‐being is vital to ensure care is holistic. This study aimed to validate the Wound‐Qol‐14 quality of life assessment tool in people with a DFU. A single centre longitudinal prospective validation study in people with DFUs was conducted. Wound‐Qol‐14, Diabetic Foot Ulcer Scale—Short Form (DFS‐SF) and EuroQol 5 dimensions 5 levels (EQ‐5D‐5L) were completed by people with DFUs at baseline and 6 months. Wound‐Qol‐14 was repeated within 7 days of the first questionnaire. Correlation coefficients with a cut off of ≥ 0.7 were used to assess convergent validity, divergent validity and responsiveness to changes in DFU severity. Reliability was assessed using Cronbach's α. The study aimed to recruit 100 people. One hundred and seven people were recruited. The mean age was 62 (SD 13) years and 85 (79.4%) were male. The mean DFU duration was 30 (SD 83) days and the mean DFU area was 6.2 (SD 10.7) cm2. Convergent validity was demonstrated in all domains of Wound‐Qol‐14 and DFS‐SF (r − 0.695 to −0.799) except burden/bothered about ulcer care domains (r = −0.443). There was moderate correlation between Wound‐Qol‐14 domains and EQ‐5D‐5L dimensions (r = 0.477–0.501). Cronbach's α ranged from 0.683 to 0.919 for the domains of Wound‐Qol‐14. Wound‐Qol‐14 was not responsive to changes in DFU severity (r = −0.291; 95% CI −0.501 to −0.048) but was responsive to healing status (healed 1.14 [IQR 0.86] vs. unhealed 1.86 [IQR 1.47]; p = 0.017). Wound‐Qol‐14 is a valid and reliable tool to measure disease‐specific quality of life in people with DFUs. Further work is needed to refine the responsiveness. EQ‐5D‐5L should be used to measure generic quality of life in people with DFUs.
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NewsBot · Jun 24, 2026

Patient-Reported Outcomes and Wound-Related Quality of Life in Adults with Diabetic Foot Ulcers Treated with Silicone Superabsorbent Polymer Dressings: Exploratory Results from a Prospective Multicenter Nonrandomized Cohort Study
David G Armstrong et al
Med Devices (Auckl). 2026 Jun 15:19:619815.

Background: Diabetic foot ulcers (DFUs) are associated with substantial clinical and economic burden and impaired health-related quality of life (HRQoL). Although wound healing remains a core endpoint, recent consensus work identifies HRQoL as an essential outcome in DFU studies. This study describes wound healing, patient-reported outcomes, function, and safety in adults with DFU treated with silicone superabsorbent polymer (SAP) dressings.

Methods: This exploratory prospective, multicenter, nonrandomized cohort study reports the DFU subgroup from a broader single-arm investigation conducted at eight specialist centers in Poland. Adults with superficial, noninfected DFUs received silicone SAP dressings for up to 6 weeks with standard offloading. Prespecified patient-reported outcome measures were the Patient Benefit Index for wounds (PBI-W) and the Wound Quality of Life questionnaire (Wound-QoL-17). Additional endpoints included wound area reduction (centralized digital planimetry), complete epithelialization, accelerometry-based activity, offloading adherence, and safety.

Results: Twenty-eight participants were included (75.0% male; mean age, 63.4 years), with a median wound duration of 166 days. By the final visit, 21 (77.8%) achieved at least 20% wound area reduction before cleansing/debridement and 24 (85.7%) after cleansing/debridement; 6 (22.2%) achieved complete epithelialization. Mean global Wound-QoL improved from 2.4 ± 0.6 to 1.5 ± 1.0 (mean change, -1.0 ± 0.8; P < 0.001), with greatest improvements in psyche and everyday-life domains. Mean PBI-W increased from 2.44 ± 0.94 to 2.94 ± 0.87 (mean change, 0.45 ± 1.10; P = 0.043). Activity intensity remained stable, offloading adherence exceeded 95%, and no device-related adverse events were reported.

Conclusion: In this prospective DFU cohort, use of silicone SAP dressings within a structured care setting was associated with improvements in wound area reduction and wound-related quality of life over 6 weeks. These results highlight the feasibility of integrating patient-reported outcomes in DFU studies and provide a clinically relevant platform for future comparative and health-economic evaluations.
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NewsBot · Jul 2, 2026

The Health-Related Quality of Life in Patients with Diabetic Foot Ulcers in Türkiye: Challenges in Diagnosis and Treatment
Mustafa Salış et al
J. Am. Podiatr. Med. Assoc. 2026, 116(4), 45; https://doi.org/10.3390/japma116040045

Background: Diabetes mellitus (DM) is a metabolic disease with an increasing global prevalence. It is characterized by chronic and systemic complications. Due to these complications, DM significantly impacts patients’ health-related quality of life (HRQoL). One of the most critical complications of DM is diabetic foot ulcers (DFUs), which have serious consequences for patients and healthcare systems. Objective: This study aimed to investigate variables potentially associated with HRQoL in patients with DFUs presenting to our wound care unit. Methods: This prospective cross-sectional study was conducted from February to May of 2023 at the Wound Care Unit of the General Surgery Department at Eskişehir City Hospital. A total of 209 patients who agreed to participate were included in the study. Data were collected via a structured questionnaire developed based on the literature, which included the Diabetic Foot Ulcer Scale–Short Form (DFS-SF). We used the Kolmogorov–Smirnov test, univariate analyses (Mann–Whitney U and Kruskal–Wallis tests), and multiple linear regression. Results: In the multivariate analysis, receipt of foot care education (p < 0.001), frequency of hospital applications due to DFU (p = 0.008), and Wagner classification (p = 0.012) were found to be predictors of HRQoL for DFUs (Adjusted R2 = 0.206, F = 4.365, p < 0.001). Conclusions: To maintain a high HRQoL among DFU patients, they should immediately apply to specialized Wound Care Units, receive education, especially regarding early diagnosis and treatment, and receive multidisciplinary management for DFU.
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NewsBot · Jul 25, 2026

The Health-Related Quality of Life in Patients with Diabetic Foot Ulcers in Türkiye: Challenges in Diagnosis and Treatment
Mustafa Salış et al
J Am Podiatr Med Assoc. 2026 Jun 29;116(4):45.

Background: Diabetes mellitus (DM) is a metabolic disease with an increasing global prevalence. It is characterized by chronic and systemic complications. Due to these complications, DM significantly impacts patients' health-related quality of life (HRQoL). One of the most critical complications of DM is diabetic foot ulcers (DFUs), which have serious consequences for patients and healthcare systems. Objective: This study aimed to investigate variables potentially associated with HRQoL in patients with DFUs presenting to our wound care unit. Methods: This prospective cross-sectional study was conducted from February to May of 2023 at the Wound Care Unit of the General Surgery Department at Eskişehir City Hospital. A total of 209 patients who agreed to participate were included in the study. Data were collected via a structured questionnaire developed based on the literature, which included the Diabetic Foot Ulcer Scale-Short Form (DFS-SF). We used the Kolmogorov-Smirnov test, univariate analyses (Mann-Whitney U and Kruskal-Wallis tests), and multiple linear regression. Results: In the multivariate analysis, receipt of foot care education (p < 0.001), frequency of hospital applications due to DFU (p = 0.008), and Wagner classification (p = 0.012) were found to be predictors of HRQoL for DFUs (Adjusted R2 = 0.206, F = 4.365, p < 0.001). Conclusions: To maintain a high HRQoL among DFU patients, they should immediately apply to specialized Wound Care Units, receive education, especially regarding early diagnosis and treatment, and receive multidisciplinary management for DFU
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NewsBot · Aug 16, 2026

The relationship between fear of falling and quality of life in older adults
with diabetic foot ulcers, Babol 2024: a descriptive-analytical study
Rahimeh Najafi Sayar et al
Source

Background. With the increase in the elderly population, the prevalence of diabetes
and its complications such as diabetic foot ulcers is increasing. Fear of falling is
regarded as a psychological factor that can disrupt the quality of life of the elderly.
This study was conducted to examine the relationship between fear of falling and
quality of life in the elderly with diabetic foot ulcers who were referred to hospitals
and infectious disease clinics of Babol in 2024.
Methods. This descriptive-analytical study was conducted on 280 older adults with
diabetic foot ulcers using convenience sampling. Data collection instruments included
a demographic questionnaire, Abbreviated Mental Test (AMT), Geriatric Fear of
Falling Measure (GFFM), and Diabetes Quality of Life (DQOL) questionnaire. Data
analysis was performed using descriptive analytical tests in SPSS software version 26.
Results. Based on the study results, the mean score of fear of falling was reported to
be 56.31±9.8 (above average). Quality of life was average in 70% of cases, favorable
in 15%, and unfavorable in 15%. Based on the results of the multiple linear regression
test, there was a statistically significant negative relationship between fear of falling
and quality of life (P<0.001, B = -0.436).
Conclusion. Fear of falling has a significantly negative relationship with the quality of
life of older adults with diabetic foot ulcers and can be a contributing factor to reduced
quality of life.
Practical Implications. The geriatric health team can design and implement targeted
educational programs encompassing fall prevention skills, awareness of risk factors,
and environmental modifications to improve the quality of life in this population
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Quality of life in those with diabetic foot ulcers

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Quality of life in those with diabetic foot ulcers

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Quality of life in those with lesser toe deformities

Foot Health Quality of Life in those with Breast Cancer

Foot Health-Related Quality of Life in Crohn's Disease

Hallux limtus and quality of life

Quality of life after fracture-related infection of the foot

Tailor's Bunion and Quality of Life

Quality of life after flat foot surgery

Share This Page

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