Implementation of spiritual care in patients with diabetic foot ulcers: a literature review
Lower extremity amputation is a complication of diabetic foot ulcers that can cause spiritual crisis. Integrating spiritual care into nursing practice is important to overcome this. However, studies articulating the role of nurses in spiritual care when caring for patients with diabetic foot ulcers is limited. This article aims to describe the importance of providing spiritual care for this group of patients. The interpretation of spiritual care with respect to the relationship between the patient and the family, and the role of the nurse are discussed. The findings offer a theoretical perspective on spiritual care that can be used to develop spiritual interventions, as well as prevent spiritual crises in patients with diabetic foot ulcers.
The International Working Group on the Diabetic Foot (IWGDF) defines diabetic foot ulcers (DFU) as full-thickness wounds of the foot presenting with infection, and destruction of skin tissue as a consequence of neuropathy and/or peripheral artery disease in patients with diabetes (van Netten et al, 2020). DFU are associated with a number of complications, such as lower extremity amputation (LEA) and mortality (Costa et al, 2017). Studies have documented that DFU complications significantly impact on subjective wellbeing and spirituality, engendering feelings of powerlessness and loss of hope for recovery (Salomé et al, 2013a; 2013b). When spiritual health is at risk, patients may experience emotional problems that hinder desired outcomes (eg delayed wound healing) (Sridhar, 2013; Britteon et al, 2017). Psychological stress retards the initial inflammatory phase of the wound healing process and affects the hypothalamic-pituitary-adrenal, sympathetic-adrenal medullary axes (Glaser and Kiecolt-Glaser, 2005; Guo and Dipietro, 2010).
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