Quality of life issues in patients with diabetes and lower extremity ulcers: patients and care givers.

The impact of lower extremity ulcers on the quality of life (QoL) of patients with diabetes and their care givers was assessed in a series of focus groups. Fourteen patients with diabetes and lower extremity ulcers and 11 care givers participated in the focus groups. Semi-structured discussions identified the issues relating to four broad QoL domains and subdomains: social (daily, leisure, family and social life), psychological (emotional health and positive consequences), physical (physical health and treatment impact) and economic (employment and finances). The patients and care givers experienced a negative impact on all domains of QoL because of the limitations in mobility caused by the ulcer which required an adaptation to a different lifestyle. A reduction in social activities, increased family tensions, lost time from work and a negative impact on general health were experienced by both groups. It is necessary to separate the impact of the ulcer from the general condition of diabetes on both patients' and care givers' QoL. The results from this disease-specific focus will allow for an improved clinical understanding with targeted interventions and contribute to the development of a disease-specific instrument to understand and measure QoL better in these individuals.