Body Image and Self-Acceptance Among Diabetes Mellitus Patients with Gangrenous Wounds: A Mixed-Methods Study

Background: Diabetes mellitus complicated by gangrenous wounds affects not only physical health but also psychological aspects, particularly body image and self-acceptance, which may influence treatment adherence and glycemic control. Objective: This study aimed to examine body image, self-acceptance, and psychological conditions among patients with diabetes mellitus and gangrenous wounds, and to explore their association with social support, spirituality, and adherence to blood sugar management. Methods: A mixed-methods design was employed. Quantitative data were collected from 60 patients using structured questionnaires assessing demographic characteristics, body image, and self-acceptance. Qualitative data were obtained through in-depth interviews with 10 participants and analyzed using thematic analysis. Quantitative data were analyzed descriptively. Results: Most participants demonstrated positive to moderate self-acceptance and body image. However, a notable proportion still experienced negative perceptions. Qualitative findings revealed that negative body image and self-acceptance were associated with feelings of stress, shame, and hopelessness, which contributed to poor adherence in blood sugar management. In contrast, family support and spirituality were identified as key factors enhancing self-acceptance and promoting adherence. Conclusion: Patients with diabetes mellitus and gangrenous wounds experience significant psychological challenges. Integrating psychosocial and spiritual support into nursing care is essential to improve self-acceptance, adherence, and overall quality of life.