Health-related quality of life of diabetic foot ulcer patients and their caregivers.
OBJECTIVE
The effect of a foot ulcer on health-related quality of life (HRQoL) of patients with diabetes mellitus and their caregivers is unclear, and was therefore evaluated prospectively in this multicentre study.


METHODS
HRQoL according to the 36-item health-related quality of life questionnaire (SF-36) of 294 patients (ulcer duration > or = 4 weeks) and 153 caregivers was analysed at baseline (time-point zero [T0]), once the ulcer was healed or after 20 weeks (time-point 1 [T1]), and 3 months later (time-point 2 [T2]). Patients with severe ischaemia were excluded.


RESULTS
The mean age of the patients was 60 years, 72% were male, and time since diagnosis of diabetes was 17 years. Patients reported a low HRQoL on all SF-36 subscales. At T1, HRQoL scores in physical and social functioning were higher in patients with a healed vs a non-healed ulcer (p<0.05). At T2, these differences were larger, with higher scores for physical and social functioning, role physical and the physical summary score (all p<0.05). Within-group analysis revealed that HRQoL improved in different subscales in patients with a healed ulcer and worsened in patients with a persistent ulcer from T0 to T2 (all p<0.05). The caregivers of patients with a persisting ulcer had more emotional difficulties at T2.


CONCLUSIONS
Diabetic patients with a healed foot ulcer had a higher HRQoL than patients with a persisting ulcer. Healing of a foot ulcer resulted in a marked improvement of several SF-36 subscales 3 months after healing (from T0 to T2). HRQoL declined progressively when the ulcer did not heal. A diabetic foot ulcer appeared to be a large emotional burden on the patients' caregivers, as well.
Nabuurs-Franssen
M H
MH
Division of Endocrinology, Department of Internal Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. marrigje.nabuurs@gmail.com
Huijberts
M S P
MS
Nieuwenhuijzen Kruseman
A C
AC
Willems
J
J
Schaper
N C
NC
D000077214:Becaplermin; D017028:Caregivers / Q000523:psychology*; D017719:Diabetic Foot / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D003929:Diabetic Neuropathies / Q000534:rehabilitation; D004311:Double-Blind Method; D006304:Health Status; D006801:Humans; D010146:Pain; D010809:Physical Fitness; D010919:Placebos; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis; D011788:Quality of Life; D011994:Recombinant Proteins / Q000627:therapeutic use; D015203:Reproducibility of Results; D012919:Social Behavior; D011795:Surveys and Questionnaires
D010919:Placebos; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D000077214:Becaplermin