ANXIETY IN DIABETIC FOOT ULCER PATIENTS

Introduction : Diabetic foot ulcers (DFUs) is the most common complication of diabetes mellitus (DM) with life time risk up to 25% of cases. DFUs are associated with increased mortality, high risk of amputation, recurrence of ulceration, poor quality of life and elevated levels of anxiety. The aim of this study was to review factors associated with anxiety among patients with DFUs. Material and Method: A literature review was conducted on English language, through Pubmed, Scopus, Science Direct and Google Scholar databases, using the key-words: "mental health", "anxiety", "diabetic foot ulcer", and "diabetes mellitus". Results : According to literature, several factors are held to be responsible for anxiety among DFU patients such as demographic, clinical or social. Anxiety seems to be higher in women, in younger patients as well as in those having an ulcer for>2 years and of low educational level. Furthermore, clinical characteristics are associated with anxiety such as duration of DM, co morbid diseases and HbA1c level of >7%. Moreover, difficulties when performing physical and personal activities due to mobility related issues might also be a source of anxiety. Additionally, an ulceration that fails to improve, provokes negative emotions, including anxiety while psychological factors may affect healing. Equally important predictors to anxiety is low social support, dependence on environment, limited self-care behavior as well as patients' views and perceptions. Conclusions : DFUs individuals should be supported to live in the severe physical, psychological and social constraints of the disease, thus alleviating anxiety