Factors Associated With Health-Related Quality of Life in Patients With Diabetic Foot Ulcer: A Cross-Sectional Study From Saudi Arabia

Epidemiological Profile of Chronic Wounds in an Indian Population: A Community-Based Cross-Sectional Observational Study

Introduction A wound that has not healed in a timely and organized manner to maintain its anatomical and functional integrity is considered chronic. It can last anywhere from four weeks to over three months and could be caused by trauma, diabetes, vascular disease, infection, or pressure. The primary objective of the study was to determine the prevalence of wounds in a rural and urban community in India, and the secondary objective was to evaluate the effect of various chronic wounds on quality of life (QoL) as assessed by the Short-Form Health Survey-36 (SF-36) questionnaire. Materials and methods The present study is a cross-sectional analytical study done between June 2022 and December 2023, and a total of 10,003 sample population was screened in Varanasi district, Uttar Pradesh, India. The study involved conducting a door-to-door survey of the population sample under interest based on a stratified sampling technique. During the survey, the epidemiological profile of the sample population, a detailed history, and clinical examination findings were recorded in a proforma. The reports of relevant diagnostic investigations were also recorded.  Results The overall prevalence of chronic wounds was 1.89 per 1000 (19/10003) population. The prevalence of wounds in urban areas was 1.57 per 1000 (11/6984) population, while that in rural communities was 2.64 per 1000 (8/3019) population. Of the total 19 patients with chronic wounds, the majority of the patients, i.e., seven each (36.8%), had diabetic foot ulcers (DFUs) and neglected/uncared trauma as the etiology for chronic wounds. The remaining five (5.3%) patients were equally divided between cellulitis, venous ulcers, trophic ulcers, tubercular ulcers, and malignancy as the etiology for chronic wounds. The QoL data suggested that 11 (57.9%) patients reported their general health status as fair with wounds, followed by five (26.3%) reporting their general health status as poor. Only three (15.8%) of the patients with wounds reported their general health condition as good. There was no significant difference between the QoL of rural and urban patients with chronic wounds. The overall prevalence of wounds has decreased from 15.03 to 1.89 per 1000 people in the survey locality. The switch from opting for home-based remedies to supervised care under the clinician (be it in a private or public setting) clearly indicates raised awareness regarding the management of wounds, and with time, people have shown an increased interest in healthcare facility treatment under supervision over adopting home remedies for wound treatment. The same domain may be attributed to the prompt management and efficacy of the management protocols by the treating physicians in India. Conclusion  The findings of the present study regarding the incidence and prevalence of chronic wounds in connection to demographic factors are important when allocating resources and making healthcare plans. The present study conveys a clear message to healthcare practitioners about the necessity of carrying out large-scale epidemiological research on this topic and offers a solid foundation for future studies.

Assessment and Factors Contributing to the Quality of Life in Diabetes Mellitus Patients: A Cross-Sectional Single-Center Study

Introduction Diabetes mellitus (DM) is one of the most common chronic illnesses worldwide, with its prevalence rising rapidly every year. This condition adversely affects vasculature, leading to several potentially devastating complications like cerebrovascular mishaps, myocardial infarction, retinal damage, and renal compromise. These sequelae could lead to serious disabilities and negatively impact quality of life (QoL). Objectives This study aims to assess the QoL of adult diabetic patients in Saudi Arabia and determine influencing socio-demographic factors. Methods This is a cross-sectional study targeting adult diabetic patients visiting the Imam Medical Center in Riyadh, Saudi Arabia, from October 2022 to June 2023. The study encompasses diabetic patients of both genders aged 18 or more but excludes those diagnosed recently, i.e., within less than one year. A validated Arabic questionnaire, available online, was used to assess the QoL of the diabetic patients enrolled in this study. The sample size was 244 adult diabetic patients recruited from the Imam Medical Center through their official social media sites. Results The cohort of 244 patients recruited in this study were mostly aged between 18 and 30 (44.7%), females (52.5%), and married (47.5%). Furthermore, 58.6% of the participants were found to hold a bachelor's degree, 48.8% were employed, and 36.1% earned less than 5000 Saudi riyals each month. Of the total patients, 36.5% were diagnosed with diabetes 1-5 years ago, while 30.5% were diagnosed 5-10 years ago. Type 1 diabetes afflicted 48.4% of participants, whereas 47.1% were affected by type 2 diabetes. It was also determined that type 2 diabetic patients have higher overall QoL scores than type 1 diabetic patients. QoL had a high mean score of 22.05±4.4. The psychological/spiritual domain has the greatest mean score of 24.06±5.4, while the social and economic domain has the lowest (20.58±4.6). The majority of participants (71.3%) did not have other chronic conditions, whereas hypertension (18%) is the prevalent comorbidity, followed by respiratory ailments (7.4%) and cardiovascular disease (3.3%). Furthermore, people with hypertension had a higher total QoL and four life domain scores than those with cardiovascular and respiratory disorders. Conclusion The relevance of the findings is that it could aid health practitioners in developing techniques to encourage patients to undertake self-care to improve physiological management of the condition and reduce complications.

Social Aspects of Diabetic Foot: A Scoping Review

Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus (DM). Patients with DFU have increased mortality and morbidity as well as decreased quality of life (QoL). The present scoping review aims to study the social issues of diabetic foot. Following PRISMA guidelines, the review was conducted in two databases (Scopus and Pubmed) with the use of the following keywords: “social aspects and diabetic foot”, “social characteristics and diabetic foot”, “social issues and diabetic foot”, “demographic profiles and diabetic foot”, “social determinants and diabetic foot”, “social capital and diabetic foot”, “social characteristics and gender and diabetic foot”, “social profiles and diabetic foot”, “social relationships and diabetic foot” and “social risk and diabetic foot”, from July to August 2021. Predetermined exclusion and inclusion criteria were selected. Forty-five studies (quantitative and qualitative) were eligible for inclusion in this review. Gender problems, socioeconomic status, social capital, and medical problems were the most important negative variables for diabetic foot. All the included variables reveal that the social impact of diabetic foot is the most important factor for management and prevention, in terms of aggravation and more, of the diabetic foot.

Health-related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross-sectional study in Singapore

Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age (β = 0.008, P < .001), non‐Chinese ethnicity (β = 0.25, P = .001), mixed ulcers (β = −0.41, P = .022), atypical hard‐to‐heal wounds (β = −0.38, P = .021), wounds with low (β = 0.24, P = .044) to moderate (β = 0.29, P = .018) exudate level, and a wound duration ≥6 months (β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.

Quality of life and adherence to mediterranean diet among type 2 diabetes mellitus patients of a primary health care clinic in Hebron city, Palestine

BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p < 0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL.