Patients and family caregivers’ perceptions on two stress reduction interventions with patients with chronic diabetic foot ulcers: a qualitative study

Abstract

Background The present study aimed to assess the perceptions of patients with chronic diabetic foot ulcers (DFUs) and their informal caregivers regarding the impact of two stress reduction interventions, such as a progressive muscle relaxation and hypnosis, on patients’ DFU and psychological wellbeing. Methods This multicenter study used a qualitative exploratory design and included individual interviews with eight patients with chronic DFUs and six family caregivers, using a semi-structured interview guide. Transcripts analysis employed thematic content analysis. Results Four key themes common to patients and their caregivers were found: 1) perspectives regarding the intervention; 2) intervention effectiveness; 3) the role of psychology on the DFU treatment; and 4) emotions and consequences associated with the DFU. Although themes were common to both treatment groups, sub-themes from the last two themes differed for patients that received muscle relaxation versus those who received hypnosis. One additional theme emerged from the caregiver’s interviews: 5) promotion of self care behaviors. Conclusion According to patients and caregivers, overall the two stress reduction interventions were beneficial for the DFU healing progression and emotional wellbeing. The hypnosis group also reported lasting effects. Participants suggested that psychological interventions such as stress reduction interventions could be included in the DFU standard treatment as an adjuvant to the clinical protocol for DFU treatment, preferably offered early on, when the patient begins treatment at the diabetic foot consultation.