Abstract
Diabetic foot ulcer (DFU) is a chronic complication that negatively affects the quality of life (QoL) of diabetic patients. In Spain, there is no specifically designed and validated instrument to assess the QoL of patients with DFU. Our aim was to adapt the Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire to a Spanish population and validate it. A prospective, observational design was used. The DFS-SF was administered by personal interview. The validated SF-36 and EQ-5D generic instruments were used as reference tools. The reliability, validity, and sensitivity to changes were assessed using standard statistical methods. A sample of 141 patients with DFU was recruited. The content validity was 3.46 on average (maximum score of 4). The internal consistency of the DFS-SF subscales showed a standardized Cronbach’s α range between 0.720 and 0.948. The DFS-SF domains showed excellent reproducibility measures (intraclass correlation coefficient from 0.77–0.92). The criterion validity was good with significant correlations between each DFS-SF subscale and its corresponding SF-36 and EQ-5D subscales (p < 0.001). However, the questionnaire structure was not validated (comparative fit index = 0.844, root mean square error of approximation = 0.095, and standardized root mean square residual = 0.093). The instrument showed high sensitivity to ulcer changes over time (p < 0.001). The adapted and validated Spanish version of the DFS-SF questionnaire has good psychometric properties and shows good sensitivity to ulcer changes, although the construct validity was not optimal. The adapted questionnaire will be a useful tool specifically to assess the QoL in subjects with diabetic foot ulcers in the clinical and research settings in Spain.
Highlights
Diabetic foot ulcer (DFU) is a condition that has a significant impact on several aspects of everyday life [1,2]
Patients with DFU are at high-risk of cardiovascular diseases in comparison with patients without this condition due to a greater burden of the disease [2]; ulceration may lead to lower-limb amputation and is associated with an increased risk of all-cause mortality [3,4]
A cross-sectional study observed that patients with DFU reported a higher perception of pain related to DFU, representing a significant clinical patient-reported outcome (PRO) [8]
Summary
Diabetic foot ulcer (DFU) is a condition that has a significant impact on several aspects of everyday life [1,2]. Patients with DFU are at high-risk of cardiovascular diseases in comparison with patients without this condition due to a greater burden of the disease [2]; ulceration may lead to lower-limb amputation and is associated with an increased risk of all-cause mortality [3,4]. For these reasons, it is important to assess the QoL of these patients. While the occurrence of a minor amputation is not associated with a poorer QoL compared with patients with active DFU [10,11], the ability to maintain mobility is related to an improved HRQoL in patients with a major amputation [10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
