Beyond the wound: A scoping review of the psychosocial impact of diabetes-related foot ulcers.

OBJECTIVES

To explore the emotional consequences of diabetes-related foot ulcers (DFUs) and examine the psychosocial factors that influence their progression, management and self care behaviours.

METHODS

A systematic scoping review was conducted following Arksey and O'Malley's six-stage framework and the Joanna Briggs Institute guidelines, and reported in accordance with PRISMA-ScR standards. Studies were eligible if they examined emotional or psychosocial experiences of adults living with DFUs.

RESULTS

Forty-nine studies were included: 28 cross sectional, 13 qualitative, 5 prospective, 2 randomized controlled trials and 1 case study. Individuals with DFUs experienced heightened emotional distress and substantially reduced health-related quality of life (HRQOL), largely due to physical limitations, challenges in diabetes self management and fear of future complications. Key psychosocial influences included low self-efficacy, feelings of powerlessness, loss of independence and perceived burdensomeness. Disparities related to gender, socio-economic status and cultural background further shaped emotional outcomes and self care behaviours.

CONCLUSIONS

Psychosocial factors substantially influence emotional well-being, treatment adherence and wound healing in people living with DFUs. Integrating psychosocial assessment, tailored education and emotional support into standard care may improve outcomes.

PRACTICE IMPLICATIONS: Routine psychological screening, health literacy-sensitive education and multidisciplinary counselling should be incorporated into DFU management to enhance self care and quality of life.