# Beyond the wound: A scoping review of the psychosocial impact of diabetes‐related foot ulcers

## TL;DR

This review explores how diabetes-related foot ulcers affect emotional well-being and how psychosocial factors influence care and healing.

## Contribution

The study provides a comprehensive scoping review of psychosocial impacts and factors related to diabetes-related foot ulcers.

## Key findings

- Individuals with DFUs experience heightened emotional distress and reduced quality of life due to physical limitations and self-management challenges.
- Psychosocial factors like low self-efficacy and perceived burdensomeness influence wound healing and treatment adherence.
- Integrating psychological screening and tailored education into care may improve outcomes for people with DFUs.

## Abstract

To explore the emotional consequences of diabetes‐related foot ulcers (DFUs) and examine the psychosocial factors that influence their progression, management and self care behaviours.

A systematic scoping review was conducted following Arksey and O'Malley's six‐stage framework and the Joanna Briggs Institute guidelines, and reported in accordance with PRISMA‐ScR standards. Studies were eligible if they examined emotional or psychosocial experiences of adults living with DFUs.

Forty‐nine studies were included: 28 cross sectional, 13 qualitative, 5 prospective, 2 randomized controlled trials and 1 case study. Individuals with DFUs experienced heightened emotional distress and substantially reduced health‐related quality of life (HRQOL), largely due to physical limitations, challenges in diabetes self management and fear of future complications. Key psychosocial influences included low self‐efficacy, feelings of powerlessness, loss of independence and perceived burdensomeness. Disparities related to gender, socio‐economic status and cultural background further shaped emotional outcomes and self care behaviours.

Psychosocial factors substantially influence emotional well‐being, treatment adherence and wound healing in people living with DFUs. Integrating psychosocial assessment, tailored education and emotional support into standard care may improve outcomes.

Routine psychological screening, health literacy–sensitive education and multidisciplinary counselling should be incorporated into DFU management to enhance self care and quality of life.

Living with a DFU is a complex and ongoing journey. From initial onset through active management and long‐term living, individuals can experience a substantial psychosocial burden, including emotional distress, treatment burden and challenges with self‐management. These psychosocial factors may influence engagement with care, treatment adherence and ultimately wound healing and clinical outcomes. This graphical summary illustrates how psychosocial experiences evolve across the DFU journey and highlights key opportunities for intervention. Integrating psychological screening, health literacy–sensitive education and multidisciplinary, person‐centred support into routine care may help reduce psychosocial burden, enhance engagement and improve outcomes for people living with DFUs. Addressing psychosocial needs is therefore essential to delivering holistic, effective DFU care.