Goodridge Donna, Trepman Elly, Embil John M
College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
J Wound Ostomy Continence Nurs. 2005 Nov-Dec;32(6):368-77. doi: 10.1097/00152192-200511000-00007.
Foot ulcers are a common, serious, and costly complication of diabetes, preceding 84% of lower extremity amputations in diabetic patients and increasing the risk of death by 2.4-fold over diabetic patients without ulcers. Health-related quality of life (HRQOL) is worse among individuals with diabetes than individuals without diabetes, and complications of diabetes, including foot ulcers, have a major negative effect on HRQOL. Diabetic foot ulcers are associated with reduced mobility and deficits related to activities of daily living that adversely affect HRQOL. Qualitative studies have confirmed clinical observations that diabetic foot ulcers have a huge negative psychological and social effect, including reduction in social activities, increased family tensions for patients and their caregivers (spouses or partners), limited employment, and financial hardship. Quantitative studies confirm the findings of qualitative studies that diabetic foot ulcers exert a negative effect on physical functioning, psychological status, and social situation. Recent advances include the development and validation of disease-specific HRQOL surveys for diabetic patients with foot ulcers. Disease-specific surveys may improve the evaluation of HRQOL as a function of ulcer healing, the effect of different treatment methods on HRQOL, and the relationship between treatment-specific HRQOL, patient compliance, and treatment efficacy.
足部溃疡是糖尿病常见、严重且代价高昂的并发症，在糖尿病患者下肢截肢病例中占比84%，与无溃疡的糖尿病患者相比，死亡风险增加2.4倍。糖尿病患者的健康相关生活质量（HRQOL）低于非糖尿病患者，糖尿病并发症，包括足部溃疡，对HRQOL有重大负面影响。糖尿病足部溃疡与活动能力下降以及日常生活活动受限有关，这些都会对HRQOL产生不利影响。定性研究证实了临床观察结果，即糖尿病足部溃疡具有巨大的负面心理和社会影响，包括社交活动减少、患者及其照顾者（配偶或伴侣）的家庭关系紧张加剧、就业受限和经济困难。定量研究证实了定性研究的结果，即糖尿病足部溃疡对身体功能、心理状态和社会状况产生负面影响。最近的进展包括为患有足部溃疡的糖尿病患者开发和验证特定疾病的HRQOL调查。特定疾病的调查可能会改善对HRQOL的评估，将其作为溃疡愈合的函数、不同治疗方法对HRQOL的影响，以及特定治疗的HRQOL、患者依从性和治疗效果之间的关系。
