A Survey of Patients' Perceptions of the Impact of Diabetic Foot Ulcers on Employment

The number of individuals of working age living with diabetes mellitus is increasing rapidly worldwide (Wild et al. 2004) and a significant percentage of this population will develop a foot ulcer at some point in their lives (Singh 2005). Diabetic foot ulcers (DFU) have been shown to impact a person’s ability to perform activities of daily living affecting their work, family and social life. The purpose of the study was to explore the experiences of working-age people living with DFUs and their perception of the impact of the condition on their employment. A self-report mixed method survey was administered to a sample of patients aged 18-65 attending an outpatient clinic for assessment and treatment of a current or previous diabetic foot ulcer. Information regarding demographics, diabetes and foot ulcer history, co-morbidities, job characteristics, employment history, productivity at work and absences related to DFUs was collected. A total of 66 patients completed the survey. Over three-quarters of the respondents (78.8%) were male and almost half (43.9%) described themselves as unable to work due to disability. Challenges facing the sample included restricted mobility, pain and concerns involving treatment protocols and the wound itself. These issues were perceived to have impacted daily work performance, time lost from work and even the ability to work at all, particularly in those with more physically active occupations. The constant need to adapt to change with an associated loss of self-identity and the difficult choices with which these patients struggle daily were highlighted. Implications for the patients themselves, family members, health care professionals and employers were identified. This small, non-random sample, study offers some descriptive insight into the lives of patients living and working with DFUs and may provide direction for future education and support for this vulnerable group.