Illness Beliefs Predict Mortality in Patients with Diabetic Foot Ulcers.
BACKGROUND
Patients' illness beliefs have been associated with glycaemic control in diabetes and survival in other conditions.


OBJECTIVE
We examined whether illness beliefs independently predicted survival in patients with diabetes and foot ulceration.


METHODS
Patients (n=169) were recruited between 2002 and 2007. Data on illness beliefs were collected at baseline. Data on survival were extracted on 1st November 2011. Number of days survived reflected the number of days from date of recruitment to 1st November 2011.


RESULTS
Cox regressions examined the predictors of time to death and identified ischemia and identity beliefs (beliefs regarding symptoms associated with foot ulceration) as significant predictors of time to death.


CONCLUSIONS
Our data indicate that illness beliefs have a significant independent effect on survival in patients with diabetes and foot ulceration. These findings suggest that illness beliefs could improve our understanding of mortality risk in this patient group and could also be the basis for future therapeutic interventions to improve survival.
Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, United Kingdom.
Kavita
K
Vedhara
School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, United Kingdom.
Karen
K
Dawe
Rand Corporation, Santa Monica, CA, 90401-3208, United States of America.
Jeremy N V
JN
Miles
Department of Psychology, University of Northumbria, Newcastle, NE1 8ST, United Kingdom.
Mark A
MA
Wetherell
School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, M13 9PL, United Kingdom.
Nicky
N
Cullum
Institute of Molecular & Experimental Medicine, University of Cardiff, Cardiff, CF14 4XN, United Kingdom.
Colin
C
Dayan
Department of Podiatry, Southmead Hospital, Bristol, BS10 5NB, United Kingdom.
Nicola
N
Drake
School of Healthcare Studies, Cardiff University, Cardiff, CF14 4XN, United Kingdom.
Patricia
P
Price
Matrix Biology Research Group, University of Bristol, Bristol, BS40 5DU, United Kingdom.
John
J
Tarlton
Institute of Pharmaceutical Sciences, King's College London, London, SE1 9RT, United Kingdom.
John
J
Weinman
Department of Clinical Biochemistry, University Hospitals Bristol, Bristol, BS1 3NU United Kingdom.
Andrew
A
Day
School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, United Kingdom.
Rona
R
Campbell
School of Computer Science & Advanced Data Analysis Centre, University of Nottingham, Nottingham, NG8 1BB, United Kingdom.
Jenna
J
Reps
School of Computer Science & Advanced Data Analysis Centre, University of Nottingham, Nottingham, NG8 1BB, United Kingdom.
Daniele
D
Soria
D000368:Aged; D001290:Attitude; D003469:Culture; D003863:Depression / Q000150:complications; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000523:psychology; D017719:Diabetic Foot / Q000401:mortality* / Q000523:psychology*; D005260:Female; D005528:Foot / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis