1362398458 psychosocial aspect of diabetic foot
TRANSCRIPT
PSYCHOSOCIAL ASPECT PSYCHOSOCIAL ASPECT OF DIABETIC FOOTOF DIABETIC FOOT
DR.ARUN BALDR.ARUN BALPRESIDENTPRESIDENT
DIABETIC FOOT SOCIETY OF DIABETIC FOOT SOCIETY OF INDIAINDIA
FOOT ULCERATION AND HIGHER LEVEL AMPUTATION RATE STILL UNACCEPTABLY HIGH INSPITE OF TECHNOLOGICAL ADVANCES
FOCUS ON PHYSICAL FACTORS HAS NOT REDUCED THE COMPLICATIONS OF DIABETIC FOOT
IT IS IMPORTANT TO ANALYSE THE PATIENT`S PERCEPTION AND THREATSPERCEIVED BY HIM REGARDING HIS PROBLEM
PRESCRIPTION OF PHYSICAL THERAPEUTIC MODALITIES LIKE OFFLOADING HAVE NO PSYCHOSOCIAL ASSESSMENT
QUALITY OF LIFE IS USUALLY NOT AN IMPORTANT COMPONENT OFTHERAPEUTIC MODALITIES IN DIABETIC FOOT COMPLICATION
WHY PSYCHOLOGICAL ASPECTSOF DIABETIC ARE IMPORTANT?
QUALITY OF LIFE IN QUALITY OF LIFE IN DIABETIC NEUROPATHYDIABETIC NEUROPATHY• WORSENING OF PHYSICAL & WORSENING OF PHYSICAL &
PSYCHOSOCIAL FUNCTIONINGPSYCHOSOCIAL FUNCTIONING• NEGATIVE IMPACFT ON QUALITY OF LIFENEGATIVE IMPACFT ON QUALITY OF LIFE• QUALITY OF LIFE IS NOT MERE HEALTH QUALITY OF LIFE IS NOT MERE HEALTH
STATUS BUT PT.`S PERCEPTION OF HIS STATUS BUT PT.`S PERCEPTION OF HIS HEALTHHEALTH
• WORSENING PHYSICAL WORSENING PHYSICAL ACTIVITY/AMPUTATION CAUSES REDUCTION ACTIVITY/AMPUTATION CAUSES REDUCTION IN SELF ESTEEM/SELF IMAGEIN SELF ESTEEM/SELF IMAGE
• CONCEPT OFNEUROPATHY QUALITY OF LIFECONCEPT OFNEUROPATHY QUALITY OF LIFE
QUALITY OF LIFE IN QUALITY OF LIFE IN DIABETIC NEUROPATHYDIABETIC NEUROPATHY• REASONS FOR REDUCED QUALITY OF REASONS FOR REDUCED QUALITY OF
LIFE: LIFE: • PAIN/PAIN/• LOSS OF SENSATIONLOSS OF SENSATION• UNSTEADINESSUNSTEADINESS• BEING TREATED DIFFERENTLYBEING TREATED DIFFERENTLY• DN SPECOFIC SCALE FOR QOL IS DN SPECOFIC SCALE FOR QOL IS
PREDICTOR OF EMOTIONAL BURDENPREDICTOR OF EMOTIONAL BURDEN
CONCEPT OF CONCEPT OF HEALTH RELATED HEALTH RELATED QUALITY OF LIFEQUALITY OF LIFE
PSYCHOSOCIAL FACTORS WHICH PSYCHOSOCIAL FACTORS WHICH LEAD TO REDUCED SELF FOOT LEAD TO REDUCED SELF FOOT CARECARE• PAST BELEIFS ABOUT SELF CAREPAST BELEIFS ABOUT SELF CARE• BELIEF ABOUT ABILITY TO PERFORMSELF BELIEF ABOUT ABILITY TO PERFORMSELF
CARECARE• CONCERRN ABOUT POTENTIAL RISK OF CONCERRN ABOUT POTENTIAL RISK OF
AMPUTATIONAMPUTATION• WILLINGNESS TO WEAR SPECIAL FOOT WILLINGNESS TO WEAR SPECIAL FOOT
WEARWEAR COSMETIC ACCEPTIBILITY,COSMETIC ACCEPTIBILITY, COSTCOST AVAILABILITYAVAILABILITY
PSYCHOLOGICAL EFFECTS PSYCHOLOGICAL EFFECTS OF ROUTINE FOOT OF ROUTINE FOOT EXAMINATIONEXAMINATION• REINFORCES IMPORTANCE OF CONCEPT OF REINFORCES IMPORTANCE OF CONCEPT OF
TISSUE INTEGRITYTISSUE INTEGRITY• REINFORCES PATIENTS AWARENES ABOUT REINFORCES PATIENTS AWARENES ABOUT
SENSORY DEFECITSENSORY DEFECIT• DEMONSTRATES AREAS OF REDUCED DEMONSTRATES AREAS OF REDUCED
SENSATION TO THE PATIENTSENSATION TO THE PATIENT• ACCEPTANCE OF THE CONCEPT OF SELF ACCEPTANCE OF THE CONCEPT OF SELF
CARE FOR DIABETIC FOOTCARE FOR DIABETIC FOOT• YEILDS LONG TERM PSYCHOLOGICAL YEILDS LONG TERM PSYCHOLOGICAL
BENEFITSBENEFITS
SOCIAL ASPECTS OF SOCIAL ASPECTS OF DIABETIC FOOT SURGERYDIABETIC FOOT SURGERY•MAJORITY ELDERLY PATIENTSMAJORITY ELDERLY PATIENTS•NUCLEAR FAMILIESNUCLEAR FAMILIES•LACK OF ACCOMODATIONLACK OF ACCOMODATION•LACK OF OPTIMAL SANITARY LACK OF OPTIMAL SANITARY
FACILITYFACILITY•COST OF THE TREATMENTCOST OF THE TREATMENT
Dr.bal
SOCIAL ASPECTS OF SOCIAL ASPECTS OF DIABETIC FOOT SURGERYDIABETIC FOOT SURGERY• DISPOSAL OF BIO HAZARDOUS DISPOSAL OF BIO HAZARDOUS
WASTEWASTE• LACK OF DOMICIALLARY LACK OF DOMICIALLARY
DRESSING FACILITYDRESSING FACILITY• LOSS OF JOBLOSS OF JOB• PERMANENT DISABILITYPERMANENT DISABILITY• LACK OF FOOTWEAR FACILITYLACK OF FOOTWEAR FACILITY
Dr.bal
PSYCHOLOGICAL FACTORS PSYCHOLOGICAL FACTORS ASSOCIATED WITH DIABETIC ASSOCIATED WITH DIABETIC FOOTFOOT • INCREASEDINCREASED• DepressionDepression• divorce ratedivorce rate• alcohol abusealcohol abuse• disruption in disruption in
social,domestic social,domestic environmentenvironment
• negative attitudenegative attitude
• DECREASEDDECREASED• diabetic self carediabetic self care• psychological psychological
adjustment to illnessadjustment to illness• social/family supportsocial/family support• self esteemself esteem• quality of lifequality of life• satisfaction with satisfaction with
treatmenttreatment
Dr.bal
FOOT ULCERSFOOT ULCERSPSYCHOLOGICAL BEHAVIORAL PSYCHOLOGICAL BEHAVIORAL FACTORSFACTORS
•IDENTITYIDENTITY•TIMELINETIMELINE•CONSEQUENCESCONSEQUENCES•CAUSECAUSE•CONTROLCONTROL
REDUCING REDUCING DISSATISFACTION IS DISSATISFACTION IS MORE IMPORTANT MORE IMPORTANT THAN INCREASING THAN INCREASING SATISFACTION FOR SATISFACTION FOR IMPROVING QUALITY IMPROVING QUALITY OF LIFEOF LIFE
MECHANISM OF MECHANISM OF DEPRESSION IN DIABETIC DEPRESSION IN DIABETIC NEUROPATHYNEUROPATHY•DIRECTDIRECT PTS REALIZATION THAT THE PTS REALIZATION THAT THE
ILLNESS IS UNCHANGEABLE PART OF ILLNESS IS UNCHANGEABLE PART OF LIFE COMBINED WITH LIFE COMBINED WITH PAIN/UNSTEADINESSPAIN/UNSTEADINESS
SENSE OF HELPLESSNESS
DEPRESSION
MECHANISM OF MECHANISM OF DEPRESSION IN DIABETIC DEPRESSION IN DIABETIC NEUROPATHYNEUROPATHY
SELF PERCEPTION AS FAMILY BURDEN
LOSS OF SELF ESTEEM AND CONFIDENCE
•INDIRECTINDIRECTPHYSICAL AND SOCIAL DYSFUNCTION
DEPRESSION REDUCED SELF CARE
ULCER
WHAT NEEDS TO BE DONE ?WHAT NEEDS TO BE DONE ?• ROUTINE PSYCHOLOGICAL ASSESSMENT OF ALL ROUTINE PSYCHOLOGICAL ASSESSMENT OF ALL
DIABETIC FOOT PATIENTSDIABETIC FOOT PATIENTS• PSYCHOLOGIST/MEDICAL SOCIAL WORKER TO BE PSYCHOLOGIST/MEDICAL SOCIAL WORKER TO BE
MEMBER OF THE TEAMMEMBER OF THE TEAM• COMMUNICATION TRAINING FOR PARAMEDICS COMMUNICATION TRAINING FOR PARAMEDICS
AND DOCTORS.AND DOCTORS.• RESEARCH IN PSYCHOSOCIAL ASPECTS IN INDIARESEARCH IN PSYCHOSOCIAL ASPECTS IN INDIA• INVOLVEMENT OF DEPT.OF INVOLVEMENT OF DEPT.OF
PSYCHOLOGY/SOCIALOGY FROM TEACHING PSYCHOLOGY/SOCIALOGY FROM TEACHING INSTITUTESINSTITUTES
MEDICOLEGAL ASPECTS MEDICOLEGAL ASPECTS OF DIABETIC FOOT OF DIABETIC FOOT SURGERYSURGERY• DODO• PT EDUCATIONPT EDUCATION• DOCUMENTATIONDOCUMENTATION• FOLLOW UPFOLLOW UP• AGGRESSIVE AGGRESSIVE
TREATMENTTREATMENT• REFER TO EXPERTSREFER TO EXPERTS
• DONTDONT• TREAT IF IN DOUBTTREAT IF IN DOUBT• IF NOT WITHIN IF NOT WITHIN
YOUR FIELDYOUR FIELD• DELAY TREATMENTDELAY TREATMENT• LET PT.GO UN LET PT.GO UN
TREATEDTREATED
Dr.bal
THANK YOUTHANK YOU