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The study included 93 diabetic patients with foot ulcers who were monitored for 24 weeks. The size of each patient's ulcer was measured at the start of the study, and again at six, 12 and 24 weeks. The researchers also assessed the participants' levels of psychological distress, coping styles and levels of the stress hormone cortisol.
The likelihood that the ulcer would heal over the 24 weeks was predicted by how an individual dealt with the situation, the study authors found. The ulcer was less likely to be healed in patients who had a "confrontational" method of coping (characterized by a desire to take control) with the ulcer and its treatment.
"My colleagues and I believe that this confrontational approach may, inadvertently, be unhelpful in this context because these ulcers take a long time to heal. As a result, individuals with confrontational coping may experience distress and frustration because their attempts to take control do not result in rapid improvements," Kavita Vedhara, of the University of Nottingham in England, said in a university news release.
The researchers also found that depression appeared to have a major effect. Patients with depression showed less ulcer improvement or healing by the end of the 24 weeks, according to the report published in the August issue of the journal Diabetologia.
The findings have led to a follow-up project to develop psychological treatments to reduce depression in patients with diabetic foot ulcers and help them cope more effectively with the condition.
Up to 15 percent of patients with type 1 and type 2 diabetes develop foot or leg ulcers, which are open sores that form when a minor skin injury fails to heal.
-- Robert Preidt
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