Attitudes and beliefs about diabetic foot ulcers can have a significant impact on the survival of patients, according to new research.

Health psychologists at England’s University of Nottingham interviewed 169 patients over five years to expand upon previous research that linked depression to poor clinical outcomes for diabetic ulcer patients. 

“We wanted to test the hypothesis that life expectancy in people with diabetic foot ulcers is shorter in patients with negative beliefs regarding their symptoms and attitudes to caring for their feet,” wrote lead researcher Kavita Vedhara, Ph.D.

The patients included in the study all received the same treatment and foot care advice. Data on the patients’ survival was collected in 2011, between four and nine years after they first joined the study. 

Of the 160 patients whose survival data was available, 104 were alive and 56 had died. Overall patients’ data showed low levels of depression.

“These patients who died also believed that their ulcers would have more serious consequences for them, believed they would last a long time, found them distressing and believed they had little control over them,” Vedhara wrote.

Findings indicate patients’ negative beliefs about diabetic foot ulcers may influence their survival, she said.

Results of the study appeared in PLOS ONE.