Quality of life and health literacy in individuals with diabetes-related wounds.

AIMS: To evaluate quality of life (QoL) and health literacy (HL) in Brazilian individuals with Diabetes Mellitus type 2 (DM2) and diabetes-related foot ulcers (DFU).

METHODS

An observational, cross-sectional study was conducted at a tertiary outpatient clinic in Southeastern Brazil. A total of 100 adult study participants, aged ≥ 18 years, who were diagnosed with type 2 DM and presented with at least one DFU were included. Instruments included a sociodemographic and clinical questionnaire, the Diabetic Foot Ulcer Scale-Short Form (DFS-SF), and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18). DFUs were classified using the Wound, Ischemia, and foot Infection (WIfI) system. Statistical analyses included comparison, correlation, and multiple linear regression tests.

RESULTS

Based on the present study, the level of diabetes HL among the study participants was inadequate. Taking into consideration the sample size, exploratory regression analyses suggest that hypertension and a moderate-to-high amputation risk (WIfI classification) were both significantly associated with poorer QoL, with respect to leisure activities and a greater perceived dependency during daily activities, respectively. Participants expressed considerable concern regarding their foot health and the challenges associated with foot ulcer management. A connection between neuropathy and increased anxiety regarding foot conditions was also found.

CONCLUSIONS

Older age, longer disease duration, hypertension, and neuropathy were associated with poorer QoL in DM patients with DFU. Although no overall association was found between HL and the DFS-SF domains, adequate HL was associated with higher scores in the "Bothered by ulcer care" domain. These findings highlight the multi-faceted impact of clinical and demographic factors on QoL in this population, and warrant further investigation using larger, longitudinal cohorts.