Biopsychosocial and adaptive changes in patients with diabetic foot

Abstract

The chronic character of diabetic foot can influence the development of psychological disorders, however, it is still necessary to understand the associations of diabetic foot with biopsychosocial conditions, functionality restrictions and the quality of life of these patients. Thus, the objective of this study was to characterize the functional and psychosocial aspects and to investigate the quality of life, anxiety and depression in patients with diabetic foot. To this end, a cross-sectional study was carried out, using questionnaires (sociodemographic, Functional Independence Scale (Kats), Quality of life questionnaire - Whoqol-Bref, Hospital anxiety and depression scale HADS), in patients with diabetes mellitus and diabetic foot treated at the vascular surgery service for 18 months in a tertiary hospital. Of the patients included, 200 had diabetic foot, met the other inclusion criteria and agreed to participate in the research. About 31% of the individuals studied had a Katz A classification (functional independence). The general quality of life determined by Whoqol-Bref was 51.1, and among the domains, the physical domain showed the lowest average, equal to 32. This finding can be associated with the low functional independence found in 31% of patients. A prevalence of 29% of depression and 23% of anxiety was observed in patients with diabetic foot. The level of amputation demonstrated a greater impact than the existence or not of amputation on patients' quality of life, resulting in even less functional independence. The difficulty to perform basic activities also influenced the increase in the prevalence of anxiety and depression.