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- Title
Importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer: the Eurodiale study.
- Authors
Siersma, V.; Thorsen, H.; Holstein, P. E.; Kars, M.; Apelqvist, J.; Jude, E. B.; Piaggesi, A.; Bakker, K.; Edmonds, M.; Jirkovska, A.; Mauricio, D.; Ragnarson Tennvall, G.; Reike, H.; Spraul, M.; Uccioli, L.; Urbancic, V.; Acker, K.; Baal, J.; Schaper, N. C.
- Abstract
Aim To identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. Methods A total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit ( R2) of the model. Results Patients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. Conclusions The factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.
- Subjects
DIABETES complications; FOOT anatomy; INFECTION prevention; PERIPHERAL vascular disease diagnosis; QUALITY of life; ULCER diagnosis; DIABETIC foot; GLYCOSYLATED hemoglobin; LONGITUDINAL method; MEDICAL care; QUESTIONNAIRES; DATA analysis; DISEASE duration; DIAGNOSIS
- Publication
Diabetic Medicine, 2013, Vol 30, Issue 11, p1382
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12254