Experiences of People with Diabetic Mellitus Foot Ulcer - Annotated Bibliography Example

Developing Ideas Name Institution Date Developing Ideas Research Question What are the lived experiences of people with diabetic mellitus foot ulcer? Hypothesis People living with diabetic mellitus foot ulcer undergo through adverse experiences such as depression, loss of self-esteem, discontent and this affects the quality of their lives. Rationale The high prevalence of diabetes mellitus and its complications such as diabetic foot ulcer is disturbing. The incidence of diabetic foot ulcer which results to experiences such as depression, loss of self-esteem, foot amputations, lack of physical mobility and such effects is inaptly high. Such effects of diabetic foot ulcer limit the lives of the patients and thus greatly affecting the quality of their lives negatively. Therefore this study is significant in order to examine the experiences individuals with diabetic foot ulcer and identify various mechanisms that can be implemented during the treatment of diabetic foot ulcer in order to lessen and prevent these effects. Objectives Specific Objective To evaluate the lived experiences of people with diabetic mellitus foot ulcer General objectives To find out if diabetic mellitus foot ulcer affects the quality of life of the patients To investigate various ways that can help in lessening the psychological effects of diabetic mellitus foot ulcer To find out if there is any relationship between diabetic mellitus foot ulcer and psychosocial status of an individual with diabetes mellitus References Alzahrani, HA, Sehlo MG., 2011, The Impact of Religious Connectedness on Health-Related Quality of Life in Patients with Diabetic Foot Ulcers, J Relig Health, [Epub ahead of print]. Bakker, K, Abbas, AG, Pendsey, S., 2006, Step by Step, Improving diabetic foot care in the developing world, A pilot study for India, Bangladesh, Sri Lanka and Tanzania, Pract Diab Int, Vol. 23, No. 8 Eliot, Cole., 2007, Psychiatric Disorders and Diabetes Mellitus, Diabetic peripheral neuropathic pain: an inevitable consequence of diabetes mellitus? Sage, California Fox, Ann., 2005, Innocent Beginnings, Uncertain Futures: The Challenges of Living with Diabetic Foot Ulcers, Canadian Journal of Diabetes, Vol. 29/2. Geraldo Magela Salomé, Leila Blanes, Lydia Masako Ferreira, TCBC-SP, Assessment of depressive symptoms in people with diabetes mellitus and foot ulcers, Col. Bras. Cir, vol.38 no.5. Gunnel Ragnarson Tennvall & Jan Apelqvist., 2000, Health-related quality of life in patients with diabetes mellitus and foot ulcers, Journal of Diabetes and its Complications,Vol. 14, Issue 5. Jaksa, P, & Mahoney, J., 2010, Quality of life in patients with diabetic foot ulcers: validation of the Cardiff Wound Impact Schedule in a Canadian population, International Wound Journal, Vol. 7/6. Matteo, Monami, 2008, The Diabetic Person Beyond a Foot Ulcer: Healing, Recurrence, and Depressive Symptoms, JAPMA, Vol. 98 no. 2 Morley, John, 1998, The Elderly Type 2 Diabetic Patients: Special Considerations, Diabet. Med, Vol. 15, No. 4. Tennvall, G., 2010, Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence, Diabetologia [Epub ahead of print]. Annotated Resources Alzahrani, HA, Sehlo MG., 2011, The Impact of Religious Connectedness on Health-Related Quality of Life in Patients with Diabetic Foot Ulcers, J Relig Health, [Epub ahead of print]. Author’s Background/ Bias/ Credibility Alzahrani, HA is the Chair for Diabetic Foot Research", Medical College, King Abdulaziz University. Sehlo MG is a principal researcher at Vascular Surgery Division, Department of Surgery, Psychiatry Unit, Faculty of Medicine. Nature of the Intended Audience The nature of the intended audience was sixty diabetic patients with foot ulcers and sixty diabetic patient without foot ulcer and sixty healthy people for evaluation of their health-related quality of life. Summary Religious connectedness is common incident within Saudi Arabia. Religious connectedness is common phenomenon in Saudi Arabia and adjacent Gulf countries. A control study enrolled 180 patients to report the relationship between religious connectedness and health-related quality of life within individuals with and without diabetes and foot ulcers. The impact of religious connectedness was evaluated through intrinsic/extrinsic religious connectedness scale. There was a close positive correlation between religious connectedness and health-related quality of life as illustrated through a positive relationship between religious connectedness scale and mental, physical aspects. In general, whereas the quality is poor within individuals having diabetic ulcers, there is a close positive correlation between religious connectedness and higher health-related quality of life. Critical Evaluation The study results show that there is a close positive correlation between religious connectedness and higher health-related quality of life. Individuals with diabetic foot ulcer often experience adverse psychological effects such as depression, which affects the quality of their lives. The religious connectedness brings emotional support because in the religion the patients are likely to be given moral and emotional support which reduces the adverse psychological that comes with diabetic foot ulcer. Relevance to the Study The results of the study indicate that religious connectedness had a positive impact on people living with diabetic foot ulcers who are often depressed. Therefore, the results of the study can have implication on improving results and this can be accomplished in my study. Bakker, K, Abbas, AG, Pendsey, S., 2006, Step by Step, Improving diabetic foot care in the developing world, A pilot study for India, Bangladesh, Sri Lanka and Tanzania, Pract Diab Int, Vol. 23, No. 8 Author’s Background/ Bias/ Credibility Karel Bakker is a MD, PhD, Internist-Endocrinologist, Chair IDF Consultative Section on the Diabetic Foot and International Working Group on the Diabetic Foot, Heemstede, The Netherlands. Zulfiqarali G Abbas is a MBBS, DTM&H, MMed Consultant Physician, Muhimbili University College of Health Science/Abbas Medical Centre, Dares Salaam, Tanzania. Sharad Pendsey is a MD, Director, Diabetes Clinic & Research Centre, India. Nature of the Intended Audience The study was targeting diabetic people with foot ulcers in the developing countries. In India, Tanzania and the neighboring nations, the estimated diabetes incidence in urban areas is between 12-14 percent and within rural areas around 1-2 percent. This indicates that India has about 40 million diabetic people while Tanzania has about one million. The figure has been projected to increase due to the longer life expectancy, sedentary lifestyles as well as changing nutritional patterns. Summary The prevalence of diabetes and its associated complication has increased at an alarming rate. The incidence of diabetic foot ulcers which results to foot amputations in most cases is equally high particularly in developing nations. The foot care initiative, Step by Step is intended to improve foot care within the developing countries and the nations that participated in this study included, Bangladesh, Tanzania, Sri Lanka and India. The objective of this project was to enhance educational skills along with the management of diabetic foot complications. Critical Evaluation The main objective of this project was to improve diabetes foot care within the developing countries through offering education for individuals living with diabetes as well as healthcare providers regarding the prevention and treatment of diabetic foot complications. According to the project’s results, the projected was successful in creating more awareness of diabetic foot problems within India and Tanzania and in providing sustainable training of healthcare providers in managing diabetic foot ulcers. In addition, the project facilitated the flow of information of from healthcare providers who were trained to other healthcare provider and therefore exporting expertise. This project was important because it aimed at reducing the risk of lower limb complication in diabetic people which is imperative. Finally, the project can empower diabetic people to take care of their feet better and obtain medical help on time whenever a foot problem occurs. As a result, the project is not only important in provider healthcare providers with more expertise in diabetic foot care but also is vital to the people living with diabetic foot ulcers since they are empowered to take care of their feet accordingly and seek medical assistance on time and all these are important in reducing diabetic foot problems. Relevance to the Study The project is a carefully designed for improving diabetic foot care and hence it provides expertise regarding steps that can be taken to take care of diabetic foot ulcers and reduce the complications that people living with diabetic foot ulcers experience. Eliot, Cole., 2007, Psychiatric Disorders and Diabetes Mellitus, Diabetic peripheral neuropathic pain: an inevitable consequence of diabetes mellitus?, Sage, California Author’s Background/ Bias/ Credibility Eliot Cole MD, MPA is a psychiatrist and pain specialist. He was granted an MD from Wake Forest University School of Medicine, an MPA from the University of Nevada Las Vegas, and an AB from the University of California. He has been a leader in the American Academy of Pain Management as well as the American Society of Pain Educators, and is generally a distinguished lecturer, educator and a consultant too. Dr. Maria D Llorente, MD has a twenty one years medical experience and practices in Geriatric Psychiatry and Psychiatry. She is an associate professor at the University of Miami, School of Medicine. Nature of the Intended Audience The intended audience is people living with diabetes mellitus who often experience diabetic neuropathy. Summary Generally, 50 percent of people living with diabetes mellitus experience diabetic neuropathy and this is the most major cause of diabetic foot ulcers. Even though most individuals with diabetic neuropathy do not experience pain, a substantial number does and this negatively affects their moods, sleep, self-worth and also qualify of their life and compromises their daily activities. Critical Evaluation The number of patient experiencing peripheral neuropathic pain is liable to rise considering the present global exponential increase in diabetes incidence as well as the rise within life expectancies for diabetic people. Therefore, there is a need to address the core concepts and assessment strategies about diabetic neuropathy along with neuropathic pain. Relevance to the Study This book analyses the concepts as well as assessment strategies about diabetic neuropathy together with neuropathic pain. Understanding diabetic neuropathy and neuropathic pain is relevant to the study since these are some of the causes of diabetic foot ulcers and they lead to negative experience among individuals living with diabetic mellitus foot ulcers. Fox, Ann., 2005, Innocent Beginnings, Uncertain Futures: The Challenges of Living with Diabetic Foot Ulcers, Canadian Journal of Diabetes, Vol. 29/2. Author’s Background/ Bias/ Credibility Ann Fox is a senior lecturer at the University of Toronto, Faculty of Medicine, Department of Nutritional Sciences and a director, Master of Public Health Program in the same University. Her key responsibilities include directing the Master of Health Science Program within Community Nutrition and the Master of Science in Community Health Program in Public Health Nutrition and she coordinates these programs, teaches and participates within practice-based research projects. She also has experience in chronic disease prevention as well as managements and specifically within the areas of diabetes care. She is a graduate of the Education Scholars Program within the Faculty of Medicine, in addition to being a member of the Pan- Canadian Task Force on Public Health Nutrition Practice. She has published other papers which include, Evaluation of a pilot module on the arts and health in a graduate community nutrition program, Canadian Journal of Dietetic Practice and Research and “Exploring the needs of front-line nurses providing home diabetes care”. Can J Diabetes 30(2), among others. Nature of the Intended Audience The intended audience includes the patients and healthcare providers. The aim of this study was to reinforce the necessity of having highly skilled, multidisciplinary teams in order to support management efforts and also make known the requirement for research initiatives that will assist the patients as well as healthcare providers to recognize and overcome the challenges of living with foot ulcers. This is because living with diabetic foot ulcers requires extensive management and the management is regularly an exasperating challenge for individuals living with diabetic foot ulcer and it needs emotional support as well as medical skills from healthcare professionals. Summary Living with diabetic foot ulcer is an exasperating and demanding condition that interrupts work, family and also social life. The study highlights three observations which include speed with which diabetic ulcers developed from tiny injuries to grave wounds; the social isolation that the immobility of treating diabetic ulcer requires and the uncertainty of the future particularly regarding to the probability of amputation. In-depth interviews were carried out with ten individuals having diabetic foot ulcer about their experiences, challenges as well as coping tactics. The interviews were recorded and recorded verbatim; the analysis of transcripts performed thematically. Basically, the study was exploring the experiences that people living with diabetic ulcer go through in order to get a better understanding of their requirements and to come up with recommendations for support improvement. Critical Evaluation The results of this study show that there is need to have improved psychosocial support, as well as ongoing foot screening and education for individuals with diabetes. This is because the results indicate that individuals living with diabetic foot ulcers are faced with several challenges within their family, social and working lives, which at times impact their self-esteem. The main challenge that people living with diabetic foot ulcer face, include daily challenges which come from the lack of physical mobility due to the diabetic foot ulcer. Relevance to the Study This study is relevant in my study because it brings out the key challenges that people living with diabetic foot ulcer face. As a result the challenges presented in this study are some of the lived experiences of individuals with diabetic mellitus foot ulcer. Geraldo Magela Salomé, Leila Blanes, Lydia Masako Ferreira, TCBC-SP, Assessment of depressive symptoms in people with diabetes mellitus and foot ulcers, Col. Bras. Cir, vol.38 no.5 Author’s Background/ Bias/ Credibility Geraldo Magela Salomé holds a PhD in Science and a Postgraduate program in Plastic Surgery from Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil. Leila Blanes holds a PhD in Science, from Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil. Lydia Masako Ferreira is a professor at Department of Plastic Surgery, Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brazil. Nature of the Intended Audience The participants in this study enrolled individuals with diabetes mellitus and diabetic foot ulcers. This study was carried to inform the healthcare providers of patient with wounds. The study reinforced the necessity of redirecting health care of patient with wounds to establish emotional disorders in these patients and recommend preventive actions. Summary Diabetic foot ulcers are common in patient with diabetic mellitus. Developments in treating these wounds allow progress in helping these patients. There is a need to thoroughly understand the complicated healing process of the wounds and the biopsychosocial elements associated with these people. Feelings like fear, dissatisfaction as well as helplessness, are frequent in wounds’ patients. Such feelings can result to depression which is one of the ten leading cause of disability globally, restricting physical, social and also personal skills. The study performed an exploratory, descriptive, analytical and cross-sectional study where 50 people with diabetes mellitus and diabetic foot ulcers were enrolled in the research. The study outcomes indicated that people with diabetes mellitus and diabetic foot ulcers showed varying levels of depressive symptoms. Critical Evaluation Diabetic foot ulcers in patients with diabetes mellitus can affect their lives considerably and can result to psychosocial disorders which include depression and hence the aim of this study was to assess the magnitude and level of depression along with the depressive symptoms that diabetic people with diabetic foot ulcers present. Basically, foot ulcers are common and their treatment is difficult and this contributes significantly to the loss of quality life. Normally, the foot ulcers are painful, reduce mobility as well as patient’s autonomy which may result to redundancy, economic losses in addition to loss of self-worth. Additionally, diabetic foot ulcers cause social seclusion because of the unpleasant appearance and odor that comes from the wound and all these aspects may result into depression for the patients. Depression has been identified as one of the leasing cause of disability and therefore this study was paramount. Relevance to the study Diabetic patients who were enrolled in this study gave their experiences of living with diabetic foot ulcers, which include depression and social isolation. The study indicated the intensity of emotional changes and their consequences for patients with diabetes mellitus and diabetic foot ulcer. Therefore, the research study is important in my study because it indicates some of the experiences that people with diabetic foot ulcers go through, for instance depression and social segregation. Gunnel Ragnarson Tennvall & Jan Apelqvist., 2000, Health-related quality of life in patients with diabetes mellitus and foot ulcers, Journal of Diabetes and its Complications Vol. 14, Issue 5 Author’s Background/ Bias/ Credibility Gunnel Ragnarson Tennvall is a member of Integrating the Healthcare Enterprise (IHE) and a principal researcher at the Swedish Institute for Health Economics, Lund, Sweden and Department of Internal Medicine, Lund University Hospital, Lund, Sweden. He has carried out paramount research in diabetes mellitus and diabetic foot ulcers which include: “Treatment Of Leg Ulcers In Sweden Still Demands Large Resources In Spite Of Improved Management—The Cost Of Illness (Coi) Estimated From A Patient Survey And Published Epidemiological Studies”, Value in Health Vol. 6, Issue 6 and “The global burden of diabetic foot disease”, The Lancet Vol. 366, Issue 9498. Jan Apelqvist is a principal researcher at Department of Internal Medicine, Lund University Hospital, Lund, Sweden. He has also carried out major studies in diabetes and diabetic foot ulcers and some of his research studies include: “Resource Utilization and Economic Cost of Care Based on a Randomized Trial of V.A.C. Therapy in The Treatment of Diabetic Foot Ulcer Wounds, Value in Health Vol. 10, Issue 3 and “Dynamic plantar pressure measurement in 49 patients with diabetic neuropathy with or without foot ulcers”, Foot and Ankle Surgery Vol. 3, Issue 4. Nature of the Intended Audience The intended audience includes diabetic patients with foot ulcers, patient having foot ulcers, the ones with primary healed ulcers and the ones who have had minor and major amputations. Summary The study was investigating health-related quality of life within patient having diabetes. Patient having foot ulcers recorded the lower quality of life level as compared to patients with healed foot ulcers. Patients who had undergone major amputations also recoded low quality of life and the quality of life was lowered by other diabetic complications. Critical Evaluation The study indicated that patients living with diabetic foot ulcers had low quality life and the ones who had undergone a major amputation indicated significantly low levels of quality of life. Diabetic foot ulcers are painful, open sores can result to major damage to soft-tissue and bone that might require amputation. This shows that diabetic foot can reduce quality of life because of decreased mobility, limited social activities, in addition to time lost from work. In addition, amputation can also increase dependency of these people further lowering the quality of their lives. Relevance to the Study The study results show that diabetic foot ulcers greatly affect the quality of life of the patient. As well, amputation also reduced their quality of life. Therefore, the study results are vital my study because they indicate how diabetic foot ulcers affect the quality of life for people living with the condition and this is relevant to the study. Jaksa, P, & Mahoney, J., 2010, Quality of life in patients with diabetic foot ulcers: validation of the Cardiff Wound Impact Schedule in a Canadian population, International Wound Journal, Vol. 7/6 Author’s Background/ Bias/ Credibility PJ Jaksa, HBSc, Division of Plastic Surgery/Wound Care, Faculty of Medicine, St Michael's Hospital, University of Toronto, Toronto, ON, Canada M5B 1W8. JL Mahoney, MD, FRCS(C), Division of Plastic Surgery/Wound Care, Faculty of Medicine, St Michael's Hospital, University of Toronto, Toronto, ON, Canada M5B 1W8 The Intended Audience The study was intended to examine and confirm the Cardiff Wound Impact Schedule (CWIS), which is a disease-specific quality-of-life measure, in people with diabetic foot ulcer. Summary The study was evaluating and validating the Cardiff Wound Impact Schedule (CWIS), which is a disease-specific quality-of-life measure, in people with diabetic foot ulcer. People living with diabetic foot ulcer have limitations due to the treatment and rehabilitation of the condition and this affects their quality of life. Due to the high number of co-morbidities in diabetes, a disease-specific quality-of-life assessment is required to evaluate the impact of foot ulcer on the quality of life. In this study, people with diabetic foot ulcers completed the CWIS and a World Health Organization generic quality-of-life questionnaire. Validity was examined through comparing the questionnaires’ domains. In addition, patients were classified by utilizing the University of Texas wound classification system. Comparison of CWIS scores was done between classifications to evaluate the capacity of the questionnaires to distinguish the severity of wound. The results of the study were that people having open ulcers scored considerably lower on the CWIS as compared to the people with healed ulcers. Additionally, the results showed that diabetic foot ulcer affected the social life as well as daily living of the patients. The study showed that Cardiff Wound Impact Schedule is effective assessment measure as a disease-specific quality-of-life measure, in people with diabetic foot ulcer. Still, the measure has the capacity of differentiating healed wounds from non-healed diabetic wounds. Critical Evaluation Since diabetic foot ulcers restrict the lives of the patients because of the treatment and rehabilitation of the condition, diabetic foot ulcers greatly affect the quality of their lives. The purpose of the study was to evaluate and validate the Cardiff Wound Impact Schedule (CWIS), which is a disease-specific quality-of-life measure, in people living with diabetic foot ulcer. This study was appropriate because the results indicate that the measure is effective and hence it is valid. As a result, Cardiff Wound Impact Schedule (CWIS) can be used widely to measure how diabetic foot ulcers affect the quality of life of people living with it and hence establish various strategies that can be used in improving the quality of life of these people. Relevance to the Study This study is relevant because the validation of the Cardiff Wound Impact Schedule (CWIS) indicates that it is effective in assessing the quality of life of people living with diabetic foot ulcer. Consequently, this measure or a comparable measure can be used in my study in assessing how diabetic foot ulcers affect the quality of life and hence indentify various experiences that such people face. Matteo, Monami, 2008, The Diabetic Person Beyond a Foot Ulcer: Healing, Recurrence, and Depressive Symptoms, JAPMA, Vol. 98 no. 2 Author’s Background/ Bias/ Credibility Matteo, Monami, MD, PhD, Geriatric Unit, Department of Critical Care Medicine and Surgery, University of Florence and Careggi Hospital, Florence, Italy. Nature of the Intended Audience The audience intended in this study was diabetic mellitus patients who are sixty years and older with foot ulcers. Summary Depressive symptoms are linked with impaired healing and reappearance of ulcers in patients with diabetes mellitus who are old. Therefore this study was examining the impact of depressive symptoms on the healing of wounds in patient with diabetic foot ulcers. In the study, successive cycle of eighty diabetic mellitus patients of sixty years and older were recruited within a group observational study with a six-month follow-up. Geriatric depression scale was used to examine depressive symptoms. The results indicated that depressive symptoms maintained a considerable relationship with persistence as well as recurrence of diabetic ulcer. Critical Evaluation Numerous studies have indicated a substantial relation between depressive symptoms and wound healing as well as wound healing but most of these studies have not evaluated the impact that the depressive symptoms have on prognosis of diabetic foot. As a result, this study was exclusively aimed to examine the role of depressive symptoms within healing and also recurrence of diabetic foot ulcers. Relevance to the Study This study is relevant in the study “lived experiences of people with diabetic mellitus foot ulcer” because the study indicates that depressive symptoms impair healing and recurrence of diabetic ulcers within elderly patient with diabetes mellitus and this is applicable in the study since this data can be used in studying some of the experiences individuals with diabetic mellitus foot ulcer undergo. Morley, John, 1998, The Elderly Type 2 Diabetic Patients: Special Considerations, Diabet. Med, Vol. 15, No. 4 Author’s Background/ Bias/ Credibility John Morley is a principal researcher at Geriatric Research, Education and Clinical Centre, St Louis VAMC and Division of Geriatric Medicine, St Louis University Medical School, St Louis, Missouri, USA. Nature of the Intended Audience The intended audience is older people living with diabetes mellitus whose impaired glucose tolerance is high because it rises with age. Summary Diabetes mellitus is common in older individuals where about 50 percent of patients with diabetes mellitus are above sixty years old. This is because even though insulin resistance increases with age, impaired insulin secretion also rises with age. Depression, weakened cognitive function are critical aspects to be considered in managing older diabetic patients who might al have weakened physical function, higher rate to injurious falls in addition to incidence of pressure ulcers and amputations. A diabetic program that incorporated healthcare providers was demonstrated to improve glycaemic control and also improve the quality of life for people with diabetes. Critical Evaluation The management of diabetes mellitus within older individuals is very challenging. Studies indicate that enhanced glycaemic control improves the quality of life for this population. As a result, if it essential to attain sufficient glycaemic control insulin therapy ought not to be avoided in older individuals. However, healthcare professionals should pay special attention to the effects of diabetes mellitus in older people, that include depression and cognitive dysfunction and therefore educational programs are supposed to focus on healthcare providers and the patients when obtaining high-quality results. In addition, this article brings out the need for the healthcare provided to raise their awareness of the necessity of diagnosing and treating diabetes mellitus on older individuals. In managing older diabetic individuals, the healthcare professionals should monitor insulin dose and determine glucose levels effectively. Relevance to the Study Diabetes mellitus is more prevalent in older people and hence this population has higher incidence of Depression, weakened cognitive function, higher rate to injurious falls as well as incidence of pressure ulcers and amputations. This is important in the study because these are some of the experiences in people living with diabetic mellitus foot ulcers. Tennvall, G., 2010, Coping style and depression influence the healing of diabetic foot ulcers: observational and mechanistic evidence, Diabetologia [Epub ahead of print] Author’s Background/ Bias/ Credibility Gunnel Ragnarson Tennvall is a member of Integrating the Healthcare Enterprise (IHE) and a principal researcher at the Swedish Institute for Health Economics, Lund, Sweden and Department of Internal Medicine, Lund University Hospital, Lund, Sweden. Nature of the Intended Audience The intended audience in this study was diabetic individuals with neuropathic or neuroischaemic diabetic foot ulcers. Summary Psychological aspects like distress affect the healing of diabetic foot ulcers. This study evaluated this hypothesis where the impact of psychological distress and coping style within the healing of diabetic foot ulcers for a period of twenty fours weeks was considered. The number of participants in this study was 93 where all the participants had neuropathic or neuroischaemic diabetic foot ulcers. The results of the study indicated that confrontation coping and depression have an effect on the healing of diabetic foot ulcer. Critical Evaluation Diabetic foot ulcers are a frequent and bring many complications to patients with diabetes mellitus. Basically, the presence of unhealed diabetic foot ulcers adversely impacts numerous domains of patient quality of life and also elevates the risk of infection, and amputation. Therefore, it is necessary to have suitable coping mechanisms that can assist in reducing psychological distress in diabetic patients with foot ulcers. Clinical studies to further expound the supportive regimens of care of diabetic foot ulcers and appropriate coping mechanisms are required. Relevance to the Study The study shows that psychological aspects like distress affect the healing of diabetic foot ulcers. Therefore, this is relevant to the study because in the study it will be possible to analyze the negative psychological factors that hinder the healing of diabetic ulcers in these patients. Read More