Relationship Between Psychological Factors and Wound Occurrence in Patients With Peripheral Arterial Disease in the Leg

Abstract

This prospective study investigated psychological factors affecting wound healing in patients with peripheral arterial disease (PAD). Fifty patients with PAD in a local hospital were enrolled. The Geriatric Depression Scale short version, Type-D scale 14, Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), Functional Independence Measure, Self-efficacy for Managing Chronic Disease Scale, Barriers Self-Efficacy Scale, and Mini Nutritional Assessment were applied to assess physical and psychological factors. Wound occurrence and healing were evaluated at 6 months after discharge, and 34 and 30 patients could be followed, respectively. The patient group with wound occurrence showed poorer mental component score (MCS) and better role/social component score (RCS) category scores of SF-36, and a higher stage in the Fontaine classification, than those without wound occurrence. On comparing Fontaine classification–matched subgroups, patients with wound occurrence showed poorer general health factor and MCS and better RCS of SF-36 than those without wound occurrence. Logistic analysis showed that MCS and RCS predicted wound occurrence and needs for local medical treatment, respectively. Among the psychological factors tested, MCS was a major factor associated with wound occurrence in the present study, with wide variation in clinical conditions and factors associated with PAD. Psychological factors were important as biological, physical, and social factors for patients with PAD during the long-term follow-up period, and an appropriate battery to evaluate psychological factors focused on patients with PAD should be developed.