Determinants of quality of life among older adults with recurrent diabetic foot ulcers

Haryanto, Haryanto and Ardhana, Putra and Abdul Wahab, Patimah (2026) Determinants of quality of life among older adults with recurrent diabetic foot ulcers. Medical Journal of Malaysia, 81 (5). pp. 661-668. ISSN 0300-5283

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Abstract

Introduction: Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus. DFUs have a profound impact on patients’ health-related quality of life (HRQoL). This study aimed to evaluate age-related variations in HRQoL and to identify factors associated with physical and mental health among patients with recurrent DFUs. Materials and Methods: A cross-sectional study was conducted among 245 patients with type 2 diabetes mellitus. HRQoL was measured using the Indonesian version of the SF-36, whereas depression, diabetes distress, and self-care adherence were evaluated using the Beck Depression Inventory II (BDI-II), the Diabetes Distress Scale-17 (DDS-17), and the Summary of Diabetes Self-Care Activities (SDSCA), respectively. Data were analysed using bivariate tests and multivariate linear regression. Results: Older adults (≥60 years) had significantly lower physical functioning and general health scores (p < 0.05). Depression (β = –0.48, p < 0.001) and diabetes distress (β =–0.25, p = 0.003) were independent predictors of poorer physical HRQoL, whereas higher self-care adherence improved HRQoL (β = 0.18, p = 0.014). Age was not a significant factor after adjustment. Physical HRQoL is poorer among older adults with recurrent DFUs, primarily mediated by psychosocial distress. Conclusion: Our findings demonstrated that psychosocial conditions, especially depression and diabetes-related distress, significantly contribute to poor HRQoL. There is a relationship between depression, distress, and poor quality of life. Moreover, depression and distress independently predicted lower physical QoL, and better self-care is a predictor of QoL. Integrated management addressing psychological well-being and self-care behaviours may enhance the overall patient outcomes.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Diabetic foot ulcer, quality of life, depression, diabetes distress, self-care adherence
Subjects:	R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing Kulliyyah of Nursing > Department of Medical Surgical Nursing
Depositing User:	Dr Patimah Abdul Wahab
Date Deposited:	07 Oct 2026 12:21
Last Update:	07 Oct 2026 12:21
Queue Number:	2026-10-Q5478
URI:	http://irep.iium.edu.my/id/eprint/131760
Indexed In:	MyCite

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