Feelings of powerlessness in patients with diabetic foot ulcers

The purpose of this study was to assess feelings of powerlessness in patients with diabetic foot ulcers. Chronic wounds affect the emotional state of patients, who may experience negative emotions including a sense of loss and powerlessness. The assessment of these feeling should contribute to the planning of interventions aimed at minimizing the impact of diabetic foot ulcers on the daily lives of these patients.

Fifty patients ≥ 18 years of age with type 1 or type 2 diabetes and foot ulcers were selected from 2 outpatient wound-care clinics to participate in the study. Of these patients, 50% were 61-70 years old, 72% were women, 74% were smokers, 10% were alcoholics, 40% had a diabetic foot ulcer for 3-6 years, and 22% for 7-10 years. Wound odor and exudate were present in 82% of patients. Individuals who were unable to respond to a questionnaire due to physical or cognitive deficit were excluded. All participants responded to the Powerlessness Assessment Tool for adult patients (PAT), with scores ranging from 12-60, with higher scores corresponding to feelings of more intense powerlessness.

Total PAT scores ranged from 31-40 for 5 (10%) patients, 51-60 for 28 (56%) patients and from 41-50 for 17 (34%) patients. All patients reported total and subscale PAT scores ≥ 34 (moderate to high scores), with a mean total score of 50.12. The maximum PAT score of 60 was reported on the "self-perception of decision-making capacity" domain.

These results indicate that patients with diabetic foot ulcers had strong feelings of powerlessness.