Table 3.
Psychological characteristics and psychosocial examination results of 209 Saudi diabetic patients by diabetic foot ulcer statusa
| Diabetic foot ulcers | Total (N = 209) | Magnitude of difference b | p-value | ||
|---|---|---|---|---|---|
| Yes (n = 45) | No (n = 164) | ||||
| Family history of psychiatric illness | |||||
| No | 36 (90.0%) | 141 (88.1%) | 177 (88.5%) | – | > 0.99 |
| Yes | 4 (10.0%) | 19 (11.9%) | 23 (11.5%) | 0.83 (0.26–2.58) | |
| Visit to psychiatrist | |||||
| No | 33 (75.0%) | 149 (90.9%) | 182 (87.5%) | – | 0.005 |
| Yes | 11 (25.0%) | 15 (9.1%) | 26 (12.5%) | 3.31 (1.40–7.86) | |
| Psychological/behavioral therapy | |||||
| No | 33 (82.5%) | 149 (93.1%) | 182 (91.0%) | – | 0.058 |
| Yes | 7 (17.5%) | 11 (6.9%) | 18 (9.0%) | 2.87 (1.04–7.97) | |
| Psychiatric medications | |||||
| No | 30 (75.0%) | 148 (93.1%) | 178 (89.4%) | – | 0.002 |
| Yes | 10 (25.0%) | 11 (6.9%) | 21 (10.6%) | 4.49 (1.75–11.50) | |
| Social support from family or friends | |||||
| No | 10 (25.0%) | 33 (20.8%) | 43 (21.6%) | – | 0.062 |
| Yes | 29 (72.5%) | 99 (62.3%) | 128 (64.3%) | 0.97 (0.43–2.19) | |
| Somewhat | 1 (2.5%) | 27 (17.0%) | 28 (14.1%) | 0.12 (0.02–1.02) | |
| Psychological deterioration after diagnosis of diabetes | |||||
| No | 21 (52.5%) | 93 (58.1%) | 114 (57.0%) | – | 0.771 |
| Yes | 10 (25.0%) | 38 (23.8%) | 48 (24.0%) | 1.17 (0.50–2.71) | |
| Somewhat | 9 (22.5%) | 29 (18.1%) | 38 (19.0%) | 1.37 (0.57–3.33) | |
| Improved family relationship after diagnosis of diabetes | |||||
| No | 9 (22.5%) | 54 (33.8%) | 63 (31.5%) | – | 0.216 |
| Yes | 23 (57.5%) | 68 (42.5%) | 91 (45.5%) | 2.03 (0.87–4.75) | |
| Somewhat | 8 (20.0%) | 38 (23.8%) | 46 (23.0%) | 1.26 (0.45–3.57) | |
| Quality of life; WHOQOL-BREF (mean ± SD) | |||||
| Domain 1: Physical health | 67.1 ± 19.2 | 71.1 ± 16.4 | 70.2 ± 17.1 | −4.0 (−9.7–1.7) | 0.263 |
| Domain 2: Psychological | 75.4 ± 14.9 | 78.0 ± 13.3 | 77.4 ± 13.7 | −2.6 (−7.1–2.0) | 0.384 |
| Domain 3: Social relationships | 77.3 ± 16.5 | 77.5 ± 17.5 | 77.4 ± 17.3 | −0.2 (−5.9–5.5) | 0.712 |
| Domain 4: Environment | 75.1 ± 16.7 | 74.7 ± 13.8 | 74.8 ± 14.5 | 0.4 (−4.4–5.2) | 0.672 |
| Overall quality of life and general health | 75.6 ± 13.2 | 75.1 ± 17.2 | 75.2 ± 16.4 | 0.4 (−5.0–5.9) | 0.891 |
| Total: All above domains | 73.2 ± 12.4 | 74.8 ± 12.0 | 74.4 ± 12.1 | −1.5 (− 5.5–2.5) | 0.539 |
| Anxiety; HAD anxiety | |||||
| Mean ± SD | 4.7 ± 4.6 | 4.1 ± 4.4 | 4.2 ± 4.5 | 0.6 (−0.9–2.1) | 0.355 |
| Normal 0–7 | 34 (75.6%) | 134 (81.7%) | 168 (80.4%) | – | 0.357 |
| Anxiety > 7 | 11 (24.4%) | 30 (18.3%) | 41 (19.6%) | 1.45 (0.66–3.17) | |
| Depression; HAD depression | |||||
| Mean ± SD | 5.7 ± 4.3 | 4.7 ± 3.7 | 4.9 ± 3.9 | 1.0 (−0.3–2.3) | 0.200 |
| Normal 0–7 | 30 (66.7%) | 127 (77.4%) | 157 (75.1%) | – | 0.139 |
| Depression > 7 | 15 (33.3%) | 37 (22.6%) | 52 (24.9%) | 1.72 (0.84–3.53) | |
| Somatic symptoms; PHQ-15 | |||||
| Mean ± SD | 6.8 ± 5.7 | 8.5 ± 6.2 | 8.1 ± 6.1 | −1.6 (−3.7–0.4) | 0.114 |
| Minimal severity (0–4) | 18 (40.0%) | 59 (36.0%) | 77 (36.8%) | – | 0.213 |
| Low severity (5–9) | 16 (35.6%) | 40 (24.4%) | 56 (26.8%) | 1.31 (0.60–2.87) | |
| Medium severity (10–14) | 7 (15.6%) | 33 (20.1%) | 40 (19.1%) | 0.70 (0.26–1.84) | |
| High severity (≥15) | 4 (8.9%) | 32 (19.5%) | 36 (17.2%) | 0.41 (0.13–1.32) | |
| Self-Management; SDSCA (mean ± SD) | |||||
| Diet | 44.8 ± 39.3 | 29.2 ± 36.9 | 32.6 ± 37.9 | 15.5 (3.1–28.0) | 0.011 |
| Exercise | 17.1 ± 26.1 | 18.7 ± 27.2 | 18.4 ± 26.9 | −1.6 (−10.5–7.4) | 0.351 |
| Blood sugar testing | 55.4 ± 37.9 | 36.1 ± 37.2 | 40.2 ± 38.1 | 19.3 (6.9–31.7) | 0.003 |
| Foot care | 50.8 ± 35.7 | 23.4 ± 33.7 | 29.2 ± 35.9 | 27.4 (16.0–38.8) | < 0.001 |
| Total | 42.2 ± 20.3 | 27.2 ± 21.2 | 30.4 ± 21.8 | 15.0 (8.0–22.0) | < 0.001 |
a Number (frequency) unless noted otherwise. Abbreviations: SD standard deviation, WHOQOL-BREF World Health Organization Quality of Life Assessment, HAD Hospital Anxiety and Depression scale, PHQ-15 the Patient Health Questionnaire Physical Symptoms; SDSCA Summary of Diabetes Self-Care Activities. b Magnitude of difference between cases and control; odds ratio (for categorical data) or mean difference (for continuous data) plus 95% confidence interval. Empty cells means reference group