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Psychosocial and Educational Implications of Diabetic Foot Complications

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The Diabetic Foot

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

In recent years, clinicians have begun to recognize the impact that ­educational, psychosocial, and behavioral factors have on treatment success for leg and foot wounds. Further, many now consider quality of life an important outcome of treatment for those suffering from neuropathy, foot ulcerations, and amputations. However, although interest is increasing, behavioral aspects of the diabetic foot remain emerging science. Researchers are only now beginning to investigate the psychological response to diabetic foot ulceration and amputation and the behavioral and psychological factors that influence self-care. Although cross-sectional studies have explored these areas, little longitudinal data currently exist. In this chapter, we review the current state of behavioral science pertaining to individuals with diabetic foot disease including barriers to prevention, precipitating factors, and therapeutic interventions. The first section describes some of the behavioral/psychological issues faced by individuals with diabetes during the course of their illness. We describe four phases of psychological responses and attempt to relate these phases to the prevention, diagnosis, or treatment of foot problems. Then, we discuss quality of life for those with peripheral neuropathy, lower extremity wounds, or amputations. Next, we discuss depression, its impact on self-care, signs and symptoms, and implications of treatment. Finally, we describe measurement instruments, strategies, and interventions that may be useful for clinicians either to incorporate into their clinical practice or as a referral for struggling patients.

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Acknowledgment

This work was supported by National Institutes of Health R01 DK60115 (K.W.).

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Authors and Affiliations

  1. Department of Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA

    Katie Weinger EdD, RN, FAADE & Elizabeth A. Beverly PhD

  2. Columbia University School of Nursing, New York, NY, USA

    Arlene Smaldone DNSc, CPNP, CDE

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  1. Katie Weinger EdD, RN, FAADE
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  2. Arlene Smaldone DNSc, CPNP, CDE
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  3. Elizabeth A. Beverly PhD
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Correspondence to Katie Weinger EdD, RN, FAADE .

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Editors and Affiliations

  1. Center, Department of Surgery, Beth Israel Deaconess Medical, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    Aristidis Veves

  2. , Division of Podiatry, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    John M. Giurini

  3. Center, Department of Surgery, Beth Israel Deaconess Medical, 110 Francis Street, Boston, 02215, Massachusetts, USA

    Frank W. LoGerfo

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Weinger, K., Smaldone, A., Beverly, E.A. (2012). Psychosocial and Educational Implications of Diabetic Foot Complications. In: Veves, A., Giurini, J., LoGerfo, F. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-791-0_25

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