Psychological burden and self-reported foot care among participants with or without diabetic foot ulcer

Background and aims: The role of personality, mood, diabetes-related distress, illness perception and self-reported foot care on the risk of diabetic foot ulcer (DFU) is currently unclear. In this study, we aimed to assess the differences in the personality, mood, diabetes-related distress, illness perception and self-reported foot care between participants with DFU versus those without DFU. We hypothesised that there is a significant difference in these psychological and self-care variables between participants with DFU versus those without DFU. Materials and methods: Consecutive participants with diabetes mellitus (DM) attending Galway University Hospitals were invited to participate in this study. Following informed consent, structured interviews were conducted using standard questionnaires to simultaneously examine aspects of personality (Type D Scale-14 [DS14] and Standardised Assessment of Personality-Abbreviated Scale [SAPAS]), mood (Patient Health Questionnaire [PHQ-9]), diabetes-related distress (Problem Areas in Diabetes Scale-5 [PAID-5]), illness perceptions (Brief Illness Perceptions Questionnaire [BIPQ]; questions relating to symptoms, perceived control and understanding of diabetes) and self-reported foot care (The Summary of Diabetes Self-Care Activities Measure [SDSCA]). Continuous variables were compared using t-tests with Levenes test for equality of variances. Categorical variables were tested using Chi-squared or Fishers exact test where appropriate. Results: One hundred and twenty participants completed the questionnaires. There was no significant difference in gender, occupational history, type of DM, HbA1c among participants with or without DFU. Participants with DFU were significantly older (65.5±9.2years vs 59.5±16.9 years; p.05), had a significantly higher BMI (34.8±7.6kg m2 vs 29.6±7.4kg m2; p0.01), longer duration of DM (18.6±12.1years vs 11.9±8.3years; p0.01) as well as, more likely to be on insulin therapy (73.7% vs 35.6%; p0.05) and have concomitant microvascular complications (26.3% vs 14.9%; p0.001). As expected, participants with DFU perceived more symptoms of diabetes, as compared with those without DFU (4.00±4.44 vs 2.36±2.46; p=0.007). Intriguingly, there was no statistical difference between participants with or without DFU in relation to the other illness perceptions examined, namely, personal control over diabetes or understanding diabetes. Similarly, there was no significant difference in personality, mood, diabetes-related distress, and self-reported foot care between the two groups. Post-hoc analysis of participants who were on insulin therapy showed no significant difference in the results for all questionnaires between those with or without DFU. Conclusion: Apart from experiencing more symptoms of diabetes and, contrary to expectations, there was no significant difference in personality, mood, diabetes-related distress, other illness perceptions, and self-reported foot care between participants with DFU versus those without DFU. Disclosure: P.T. Murphy: None.