Feelings of powerlessness in individuals with either venous or diabetic foot ulcers

To assess feelings of powerlessness in patients with either venous or diabetic foot ulcers.

This was an exploratory, descriptive, cross-sectional study conducted from May 2010 to August 2012. Two hundred adult patients with either venous leg ulcers (N=100) or diabetic foot ulcers (N=100) were consecutively recruited from an outpatient wound care clinic of a university hospital in the city of São Paulo (Brazil). Eligibility criteria included patients with type 1 and 2 diabetes and foot ulcers, and those with venous leg ulcers and ankle-arm index between 0.8 and 1.0. Patients unable to respond to a questionnaire due to physical or cognitive deficit were excluded. Two instruments were used for data collection: a questionnaire assessing sociodemographic and clinical characteristics, and the Powerlessness Assessment Tool (PAT) for adult patients.

Most patients were women, aged 60-70 years, and smokers. Fifty-seven patients (57%) with diabetes had had foot ulcers for 3-6 years and 55 (55%) patients had had venous ulcers for 7-10 years. Wound odor and exudate were present in most ulcers. The total PAT score was significantly higher (P=0.002) for patients with foot ulcers (mean, 57.10) than for patients with venous ulcers (mean, 55.12). The highest mean scores for patients with venous and diabetic foot ulcers were 58.09 and 58.10, respectively, on the "self-perception of decision-making capacity" domain.

Patients with venous and diabetic foot ulcers had very strong feelings of powerlessness, but these feelings were significantly stronger in those with foot ulcerations.