Body Image as a Mediator Between Gender and Quality of Life Among Patients With Diabetic Foot Ulcers in Indonesia

Introduction: Foot ulcers cause women in Indonesia to lose opportunities to participate in religious and cultural activities due to the inability to wear certain footwear. This study examined body image as a mediator in the relationship between gender and quality of life (QoL) among patients with diabetic foot ulcer (DFU) in Indonesia. Method: A cross-sectional design with convenience sampling was used to recruit participants at the Surgical Outpatient Department and Wound Care Clinic in Bali, Indonesia. The Diabetic Foot Ulcer Scale–Short Form and the body image domain of the Body Investment Scale were administered. Results: We found gender differences in participants’ (n = 201) QoL and body image (p < .05). Body image fully mediated the effect of the relationship between gender and QoL (B = 6.68; 95% confidence interval [3.14, 10.52]) and explained 39.13% of the variance. Discussion: Health care providers should consider patients’ religious beliefs in DFU education and consider women’s body image issues. Diabetes foot ulcer may prevent women from performing religious rituals, thus, influencing their QoL. Protective strategies to prevent DFU among women in Indonesia warrant further development.