Statistical analysis:

Data was analyzed using the Statistical program for social Sciences
(SPSS) version 16. Descriptive statistics was used the means and standard
deviations (SD) for continuous variables and used the frequency distribution
for categorical variables. One-way Analysis Of Variance (ANOVA) used to analyze
the differences among group means and their associated procedures. Multivariate
Analysis of Variance used to examine the net effect for each of the independent
variables on overall and its various categorical levels of quality of life
scales and its dimensions or summaries. A P-value of ? 0.05 considered
significant.

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The study was approved by the ethics committee of NCDEG; all
patients were provided with a written informed consent before entering the
study.

 

Results

Participants’ characteristics:

A total of 144 participants aged between 24 and 90 years with a
mean age (SD) of 56.8 (11.0) were included in the study. The socio-demographic,
anthropometric and clinical characteristics of the study population were
presented in Table 1 and Table 2.

Quality of life and subscales scoring:

The overall average score of DFS-SF was 42.1 (17.0).Table 3 shows
the mean (SD) scores of the six subscales of DFS-SF. The mean scores were 36.7
(20.1) for Leisure/ Enjoying life, 44.2 (22.6) for Physical health, 48.2 (25.7)
for Dependency/ Daily life, 43.5 (24.6) for Negative emotions, 32.7 (24.2) for Worried
about ulcer, 46.1 (27.8) for Bothered by ulcer care, 39.3 (9.9) for Physical
Component Summary-8 and 41.9 (11.1) for Mental Component Summary-8. The summary
scores showed a lower Physical Component Summary score than Mental Component
Summary score.

Association between
socio-demographic characteristics with quality of life mean scores:

As shown in table (4); Male gender, ? High school level of
education, no stressful events in the last year, not having PVD, absence of
soft issue infection, lower wagner classification Grade and normal body weight
were significantly associated with higher DFS-SF scores, indicating better
quality of life. The factors associated with PCS8 and MCS8.

 Association between socio-demographic, clinical and foot
ulcer, characteristics with quality of life subscales:

As shown in table (5); higher score on leisure subscale was noticed
in males, those with no more than one ulcer or not wearing TCC and in patients with
no dyslipidemia.

Patients who were males, married, with educational level more than
high school and with family monthly income more than 500 JDs scored higher on
physical health subscale.

Dependency subscale was shown to be significantly associated with
duration of foot ulcer, site of the ulcer, presence or absence of hypertension,
ischemia, type offloading devices, presence of absence of osteomyelitis,
charcot foot, amputations or wagner classification grade and retinopathy.

Additionally, males, married, employed, with educational level more
than high school, with no stressful life events and those with ulcer location
either in the forefoot or midfoot scored higher on negative emotions subscales.
On the other hand, patients with educational level more than high school, with
no stressful life events and no ischemia were more worried about their ulcers
than their counterparts. Finally, bothered by ulcer care subscale was
significantly affected by offloading devices, having amputation or not, wagner
classification grade and BMI. 

In summary, Stressful events, increased duration of ulcer, having
Hind-foot ulcer, having more than one ulcer, Ischemia, osteomylitis, charcot
foot, amputation, retinopathy, higher grades of wagner classification,
hypertension, dyslipidemia, and obesity were significantly associated with
decreased scores on at least one DFS subscales.