Page 149 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

124 Chapter 5. Different Wound Type

and an incapability to perform daily activities. Furthermore,
given that the treatment of diabetes-related foot disease
demands a multi-disciplinary approach with treatments that
are often intensive and prolonged frequent hospitalisations
may result (Hogg et al. 2012 ). These consequences can sub-
sequently negatively impact upon a patient’s quality of life.
Not only do these, like the other wounds discussed, impact on
a patient’s physical functioning, but also on their social and
psychological status (Londahl et al. 2011 ). Much research has
highlighted these consequences with patients often reporting
reduced mobility as a major factor impinging on their QoL
(Hogg et al. 2012 ; Chapman et al. 2014 ; Ribu and Wahl 2004 ),
followed by having to adapt to the lifestyle changes needed
to live with ulcerations on the foot.
A number of studies have reported that individuals with
diabetic foot ulcers are faced with a variety of negative
emotional and psychological consequences. Research has
highlighted how due to the lack of mobility, many patients
are faced with feelings of frustration, anger and guilt (Brod
1998 ; Kinmond et al. 2002 ; Watson-Miller 2006 ). These feel-
ings often stem from the restrictions patients perceive. It is
important to note that these are often perceptions rather
than reality and it is therefore incumbent on the clinician to
ensure that appropriate education and support is provided
to the patient, along with any practical remedies to improve
their mobility.
Not surprisingly, those individuals with DFU have sig-
nificantly poorer psychosocial states than those with diabe-
tes but without a foot ulcer (Fejfarova et al. 2014 ). Indeed,
Fejfarova et al. ( 2014 ) reported that those with a DFU had a
lower quality of life in key areas: finances, standard of living,
employment status, isolation and financial hardship. Similarly,
there were reports of lower levels of social support and self-
care. Not surprisingly, levels of suicidal ideation were also
relatively high (approximately 5 %).
Other research has also highlighted a high prevalence of
depression amongst those with a DFU. For example, phe-
nomenological research conducted by Kinmond et al. ( 2002 )
interviewed a number of patients who had an ulceration.