Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis

Abstract

Purpose To undertake a systematic review of the literature to investigate the HRQOL among adults living with DFUs. Methods A systematic search of the medical and nursing/health content databases including MEDLINE, CINAHL, and PsycINFO was conducted up to November 2018. The methodological quality of each study was assessed independently by all authors using the Joanna Briggs Institute checklist. Data analysis was conducted using the Comprehensive Meta-analysis software. All analyses were performed using random-effects models and heterogeneity was quantified. Results A total of 12 studies were included in the review. Overall, the HRQOL of participants in the studies was poor on four of eight subscales in the SF-36: physical functioning (mean = 42.75, SE 1.5); role physical (mean = 20.61, SE 3.4); general health (mean = 39.52, SE 1.7); and vitality (mean = 45.73, SE 2.8). In addition, presence of pain, high levels of C-reactive protein (> 10 mg/L), ulcer size > 5 cm 2 , Ankle Brachial Index < 0.9, high glycosylated haemoglobin and body mass index > 25 kg/m 2 were associated with poorer HRQOL in people with DFUs. Conclusions This review has provided evidence indicating that people with DFUs have a significantly lower HRQOL. Evidence-based interventions to improve the HRQOL in this group of people is needed.

Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study

“…There are numerous instruments used to measure the HRQOL in Thai people with T2DM, however the majority of these are generic and not disease specific instruments [7, 17, 24–26]. A systematic review revealed the need for the use of a validated disease specific instrument to measure HRQOL in patients with T2DM [27]. Hence, the Health-related quality of life (HRQOL) was assessed using the Thai version of the Diabetes-39 questionnaire.…”

“…Presence of diabetic foot ulcers (DFUs) has also been reported to have a negative effect on several domains of a person’s HRQOL including daily and social activities [20]. Results from a recent systematic review that included 11 studies of people with DFUs identified that the HRQOL of participants in most of the studies was poor, particularly in physical functioning, role physical, general health, and vitality [21]. Furthermore, people experiencing pain due to a DFU have an even lower HRQOL [22].…”

Associations of foot ulceration with quality of life and psychosocial determinants among patients with diabetes; a case‐control study

“…While this correlation has been shown in other types of patients [37], we could not identify studies that examined the severity of somatic symptoms in relation to quality of life among patients with diabetic foot ulcers. The negative impact of somatic symptoms on quality of life may be mediated by pain and psychological symptoms [12, 37, 38]. Interestingly, the impact of pain on activity is part of the physical component of quality of life in both the WHOQOL-BREF and SF-36 [12, 30].…”

Psychosocial research in the diabetic foot: Are we making progress?

“…Research indicates that DFUs have detrimental effects on health status and QoL. 1 The loss of mobility caused by non-weight-bearing treatment is central to patients' experience with DFU, leading to restrictions in activities of daily living. 2 Furthermore, DFUs limit performance of important social and family roles.…”