Determinants of quality of life among older adults with recurrent diabetic foot ulcers.

INTRODUCTION

Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus. DFUs have a profound impact on patients' health-related quality of life (HRQoL). This study aimed to evaluate age-related variations in HRQoL and to identify factors associated with physical and mental health among patients with recurrent DFUs.

MATERIALS AND

METHODS

A cross-sectional study was conducted among 245 patients with type 2 diabetes mellitus. HRQoL was measured using the Indonesian version of the SF-36, whereas depression, diabetes distress, and self-care adherence were evaluated using the Beck Depression Inventory II (BDI-II), the Diabetes Distress Scale-17 (DDS-17), and the Summary of Diabetes Self-Care Activities (SDSCA), respectively. Data were analysed using bivariate tests and multivariate linear regression.

RESULTS

Older adults (≥60 years) had significantly lower physical functioning and general health scores (p < 0.05). Depression (β = -0.48, p < 0.001) and diabetes distress (β = -0.25, p = 0.003) were independent predictors of poorer physical HRQoL, whereas higher self-care adherence improved HRQoL (β = 0.18, p = 0.014). Age was not a significant factor after adjustment. Physical HRQoL is poorer among older adults with recurrent DFUs, primarily mediated by psychosocial distress.

CONCLUSION

Our findings demonstrated that psychosocial conditions, especially depression and diabetes-related distress, significantly contribute to poor HRQoL. There is a relationship between depression, distress, and poor quality of life. Moreover, depression and distress independently predicted lower physical QoL, and better self-care is a predictor of QoL. Integrated management addressing psychological well-being and self-care behaviours may enhance the overall patient outcomes.