Role of hospital anxiety and depression on the healing of chronic leg ulcer: A prospective study

Abstract

A chronic leg ulcer is a debilitating illness, owing to the local condition of the wound and a decrease in physical activity and productivity, resulting in anxiety and depression among patients. The study aimed to find any association of anxiety and depression in the healing of chronic wounds. A total of 125 patients with chronic leg ulcers were enrolled in the study. HADS questionnaire assessment followed the local wound examination in all patients. A follow‐up assessment of the ulcer was done after appropriate local treatment, and data analysed with the HADS scale. In the present study, the ROC curve showed a cutoff value of 14 for the HADS score in predicting ulcer status (non‐healing vs healed) after 30 days. A total of 54.4% (68) patients had a HADS score ≥ 14 and 39% (49) were true positive for the non‐healing wound at a 1‐month follow‐up. This study revealed a sensitivity and specificity of 83.1% and 71.2%, respectively (P‐value <.001), and diagnostic accuracy of 76.8%, for HADS score > 14 in the detection of non‐healing ulcers. Chronic leg ulcers should be subjected to HADS assessment and if found significant corrective measures must be instituted for improving wound healing.

Risk factors for delayed healing or non-healing of venous leg ulcers in adults: a systematic review protocol

“…These ulcers can be debilitating, having a major impact on a person's life, often with disease distress symptoms including pain, decreased physical functioning, immobility, sleep disturbance, lack of energy, limitations in leisure activities, worries and frustrations, lack of self-esteem and a substantial negative impact on health-related quality of life 13 . Many published studies report risk factors for delayed/ non-healing of VLUs [14][15][16][17][18][19] ; however, to date, there have been no systematic reviews that we could find and only limited reviews of risk factors [20][21][22][23] , particularly those that include non-physiological factors, due to a range of definitions, methodological inconsistencies in data collection, and measurement of risk factors 20 . Previously reported studies have consistently concluded risk factors as being a larger ulcer area, a longer ulcer duration, a previous history of ulceration, venous abnormalities and a lack of high compression 20 .…”