242. Correlation between anxiety symptoms and psychological rehabilitation in patients with diabetic foot ulcer

Abstract Background Diabetic foot ulcers, as one of the serious chronic complications of diabetes, not only cause limb pain, restricted movement and increased risk of infection in patients, but also often accompany significant psychological distress, especially anxiety symptoms. Anxiety may further affect patients' treatment compliance, self-management behavior and overall rehabilitation process. However, systematic research on the association between anxiety symptoms and psychological rehabilitation in patients with diabetic foot ulcers is still relatively insufficient at present. Therefore, the study adopted a scheme combining cross-sectional investigation and longitudinal follow-up, aiming to explore the correlation between anxiety symptoms and the psychological rehabilitation level of patients with diabetic foot ulcers. Methods A total of 120 patients diagnosed with diabetic foot ulcers were recruited for the study. Their Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 Scale (GAD-7). And the level of psychological Rehabilitation was evaluated using the Diabetes Psychosocial Rehabilitation Assessment Scale (DPRAS). Meanwhile, the sociodemographic data of the patients, the severity of ulcers, the course of the disease and clinical indicators such as glycated hemoglobin were collected. Three months later, the same batch of patients were followed up again to reevaluate the above psychological indicators, and the ulcer healing situation and readjustment rate were recorded. Correlation analysis, multiple linear regression and path analysis and other methods were adopted to investigate the association between anxiety symptoms and various dimensions of psychological rehabilitation and its changing patterns over time. Results The results showed that the anxiety symptoms (total score of GAD-7) of patients with diabetic foot ulcers were significantly negatively correlated with the total score of psychological rehabilitation (r = -0.62, p<.01). After controlling for factors such as clinical severity, anxiety symptoms remained an independent predictor of psychological rehabilitation level (β = -0.48, p<.001). The longitudinal analysis results indicated that the psychological rehabilitation score of the high anxiety group was (52.7 ± 6.1) during follow-up, which was significantly lower than that of the low anxiety group (73.4 ± 5.9) (p<.01). Meanwhile, the complete ulcer healing rate in the high anxiety group (32.4%) was significantly lower than that in the low anxiety group (58.6%) (p<.05). Discussion The research results show that anxiety symptoms are closely related to the psychological rehabilitation level of patients with diabetic foot ulcers. A higher degree of anxiety not only corresponds to poor psychological adaptation and quality of life, but may also have an adverse impact on ulcer healing and clinical prognosis. In the routine treatment of diabetic foot ulcers, anxiety should be systematically screened and actively intervened, and incorporated into the overall rehabilitation management framework. Future research can verify the effect of psychological and behavioral intervention integrating anxiety management on promoting the physical and mental recovery of patients by designing randomized controlled trials, and explore its potential mechanism of action in combination with physiological indicators (such as cortisol and inflammatory factors), thereby promoting the in-depth development of the rehabilitation model for diabetic foot ulcers towards the integration of body and mind.