Impact of chronic wound on quality of life among diabetic foot ulcer patients in a selected hospital of Guwahati, Assam, India.

Abstract

Background: Diabetic foot ulcer (DFU) is an important mortality factor among diabetes mellitus (DM) patients and has a massive impact on the quality of life (QoL) of patients. The non-heal foot ulcer needs extra care and need special attention in maintaining wound hygiene. Dressing on wound is done in four stages such as cleanse the wound, debridement of wound, fashioning of edges and final dressing. The important stage of cleanse the wound was done with solution extracted from neem leaves which has medicinal value and anti-biotic properties and was used instead of normal saline or water solution, which do not carry medicinal value. Other medicinal solutions are of high cost as well as not easily available such as octanedione dihydrochloride or hypochlorous acid etc.

Aims: This study was aimed to investigate the impact of DFU on QoL among patients suffering from chronic wounds.

Materials and methods: A cross-sectional, descriptive study was conducted at foot care clinic in a private hospital situated at Guwahati, Assam. Data were collected using a pro forma consisting of sociodemographic variables, Wagner ulcer classification and Cardiff wound impact questionnaire. Analysis of data was done using the descriptive and inferential statistical methods.

Results: A total of 118 DFU patients of type 1 and 2 DM were studied. Out of which, 81.4% were male and 18.6% were female. About 66 participants (55.9%) were in grade 2 and 38 (32.2%) were in grade 3 of Wagner ulcer classification. Overall mean score for QoL was 6.27, whereas overall mean score for satisfaction on QoL was 7.01. Patients had the highest score in the well-being domain and lowest in the social life stress. Computation of correlation matrix and factor analysis showed a positive correlation between QoL and satisfaction and negative correlation between QoL and satisfaction with stressful experience of social life and physical symptoms experience (P < 0.05, 0.01). Multiple regression analysis reveals that satisfaction had a significant impact on QoL (P < 0.001) with r² = 62.59%. Factor analysis of correlation matrix showed that physical symptoms and daily living experiences and social experiences as well as stress dominated factor 1 followed by satisfaction led QoL in factor 2 and social life stress was the leading force in factor 3.

Conclusion: QoL of patients with DFUs can be improved by educating the diabetic patients on the prevention and early detection of foot ulcers, other diabetic complications, and availing benefits of prevailing health-care facility in early stages.