Investigating the Effect of Bromelain Capsules on Stress, Anxiety and Depression in Patients with Diabetic Foot Ulcers

Depression and stress are common among individuals with diabetic foot ulcers. The purpose of this study was to find whether bromelain can alleviate these symptoms. This single blind, two-group clinical trial study was conducted in 2023. Eighty people with diabetic foot ulcers in specialised wound clinics of Tehran University of Medical Sciences were selected and randomly assigned to the test and control groups. The test group received capsules containing 500mg of bromelain twice a day for four weeks, and the control group received the same amount and number of placebos. After the intervention, the DASS-21 was completed again by the participants. The mean scores of depression, anxiety and stress of people with diabetic foot ulcers in the test group before taking bromelain were 16.02 ± 1.44, 11.62 ± 1.25 and 13.65 ± 1.81 respectively. After the intervention, they were 10.45 ± 1.44, 7.25 ± 1.17 and 10.80 ±1.72 respectively. The mean of this index in the control group before the intervention was 15.50 ± 3.25, 11.55 ± 3.43 and 13.22 ± 3.33. After the intervention, it reached 15.15 ± 1.87, 12.22 ± 2.15 and 13.17 ± 2.34. There was a statistically significant difference between the mean indices of depression (p=0.00), anxiety (p=-0.02) and stress (p˂0.001) in the test group before and after the intervention. However, this difference in the control group was not significant (p ≥ 0.05). The core of caring for patients with chronic diseases involves using safe and low-complication treatment methods. The study findings show that bromelain capsules can effectively alleviate depression, anxiety and stress. Therefore, it is recommended that healthcare providers, especially nurses, consider using bromelain for patients with diabetes and other acute and chronic diseases.