A Patient's Non-Adherence to the Treatment of Diabetic Foot Ulcers: Longitudinal Case Study

Abstract

introduction: On average, diabetic foot ulcerations heal within 3 to 6 months. By adhering to treatment measures this period can be shortened and re-ulcerations prevented. aims: To analyze the causes and risk factors of re-ulcerations/recurrences/relapses of diabetic foot ulcers (DFU) on 1 case, to assess the effects of the applied treatment measures, and to suggest more effective methods to maintain motivation to treatment and successful healing of diabetic ulcerations. Methods: A case study of a client diagnosed with DFU who was monitored, treated and educated in a vascular-surgical outpatient ward for 11 years (2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021). For data collection we used monitoring, tests and scales, an interview, a medical documentation analysis including laboratory, physical, clinical and anthropometric indicators, and a DFU photo documentation. result: A long-term DFU treatment (local surgical and wound therapy, pharmacological, short education about regimen measures) caused the client's loss of motivation and nonadherent behavior manifested by his nonadherence to the prescribed regimen measures (diet, relieving the ulcers), worsening of laboratory indicators (HbA1c), physical indicators (hypertension), clinical indicators (nonhealing scum of the wound, re-ulceration, infection), anthropometric indicators (BMI), insufficient treatment efficacy, and worsening of the prognosis of DFU (amputation). The fact that there were no physical inspections during the covid pandemic made this condition even worse. conclusion: Despite a long DFU treatment the client's DFU did not heal. Such a longterm patient must not only be educated but also led and supported, positively motivated to undergo treatment and to adhere to the regimen measures through life values, individual lifestyle, and open partnership with healthcare professionals.