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The Relationship Between Frailty and Care Dependency in Patients with Diabetic Foot Ulcers: A Structural Equation
Busra Gurcay1, Aylin Bilgin2, Havva Sert3
1Internal Medicine Nursing Department, Institute of Health Science, Sakarya University.
Advances in Skin & Wound Care
|May 20, 2026
Summary
Nearly all diabetic foot ulcer patients are frail. Physical frailty significantly predicts care dependency, highlighting the need for early nursing interventions to improve patient outcomes.
Area of Science:
- Gerontology
- Diabetology
- Nursing
Background:
- Diabetic foot ulcers are a significant complication of diabetes.
- Frailty, encompassing physical, psychological, and social factors, is increasingly recognized as a predictor of adverse health outcomes.
- Care dependency can arise from various health conditions, impacting patients' quality of life.
Purpose of the Study:
- To determine the prevalence of frailty and care dependency in patients with diabetic foot ulcers.
- To examine the effects of physical, psychological, and social frailty on care dependency in this population.
- To utilize structural equation modeling to analyze these relationships.
Main Methods:
- A descriptive study design incorporating structural equation modeling.
- Inclusion of 302 patients diagnosed with diabetic foot ulcers.
- Data collection via face-to-face interviews using the Tilburg Frailty Indicator (TFI) and Care Dependency Scale (CDS).
Main Results:
- A high prevalence of frailty was observed, with 96.4% of participants scoring positive on the TFI.
- Physical frailty, age, and duration of diabetes diagnosis were significant predictors of care dependency.
- Psychological and social frailty did not show a significant effect on care dependency.
Conclusions:
- The study confirms a near-universal prevalence of frailty among patients with diabetic foot ulcers.
- Physical frailty emerges as a key determinant of care dependency, despite a generally high level of independence in daily care.
- Early assessment of frailty by nurses and targeted interventions are recommended to mitigate care dependency and enhance patient well-being.
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