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Published in: Journal of Diabetes & Metabolic Disorders 2/2021

01-12-2021 | Care | Research article

Challenges and Expectations of Diabetic Foot Care from the Patients’ Point of Views

Authors: Maryam Aalaa, Neda Mehrdad, Shoaleh Bigdeli, Afsaneh Dehnad, Zohreh Sohrabi, Kamran Soltani Arabshahi

Published in: Journal of Diabetes & Metabolic Disorders | Issue 2/2021

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Abstract

Introduction

Diabetic foot ulcer (DFU) as a common complication of diabetes needs a multi-disciplinary care approach in which the patient suffering from DFU is considered as a member of the care team. According to the effective role of patients in DFU prevention and management, this study was an attempt to explore patients’ views and expectations regarding provision of DFU preventive and therapeutic care to facilitate the process of care and management.

Methods

A qualitative research approach, using two focus group discussions, was conducted with patients suffering from diabetes and DFU. The questions designed to encourage the discussion were focused on the patients’ experience of foot and DFU care. We continued the discussions until we reached data saturation. The participants’ responses were recorded via a recorder and by taking notes. Afterwards, the discussions were transcribed and common themes were identified and categorized.

Results

Initially, fifty-seven codes were extracted which were then summarized and classified. Afterward, three themes and six sub-themes were determined as follows: defective education and ineffective communication("a defect in the patient education system", "impaired communication"), multi-faceted challenges of wound healing ("out of pocket expenses, treatment compliance", "non-physical injury"), and full support ("empathy" and "patient-centeredness").

Conclusion

According to patients’ views, patients’ concerns, and their socioeconomic conditions should be taken into consideration in designing an effective DFU care plan. In this regard, a strong communication with the patients to prepare a holistic care intended for patients’ full support would be essential.
Literature
1.
go back to reference Guo Y, Zhao J, Wang H, Liu S, Huang T, Chang G. Metabolic Disorder-Related Hypertension. Secondary Hypertension: Springer; 2020. p. 507–45. Guo Y, Zhao J, Wang H, Liu S, Huang T, Chang G. Metabolic Disorder-Related Hypertension. Secondary Hypertension: Springer; 2020. p. 507–45.
2.
go back to reference Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice. 2019;157:107843 Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice. 2019;157:107843
3.
go back to reference Apelqvist J. The diabetic foot syndrome today: a pandemic uprise. The Diabetic Foot Syndrome. 26: Karger Publishers; 2018. p. 1–18. Apelqvist J. The diabetic foot syndrome today: a pandemic uprise. The Diabetic Foot Syndrome. 26: Karger Publishers; 2018. p. 1–18.
4.
go back to reference Buowari OY. Diabetes mellitus in developing countries and case series. Diabetes mellitus-Insights and Perspectives Rijeka, Croatia: InTechOpen. 2013:131 Buowari OY. Diabetes mellitus in developing countries and case series. Diabetes mellitus-Insights and Perspectives Rijeka, Croatia: InTechOpen. 2013:131
5.
go back to reference Pedrosa HC, Bahia LR. Burden of Diabetic Foot Disease in Brazil. The Foot in Diabetes. 2020:61–5 Pedrosa HC, Bahia LR. Burden of Diabetic Foot Disease in Brazil. The Foot in Diabetes. 2020:61–5
6.
go back to reference Saluja S, Anderson S, Hambleton I, Shoo H, Livingston M, Jude E, et al. Foot ulceration and its association with mortality in diabetes mellitus: a meta-analysis. Diabet Med. 2020;37(2):211–8.CrossRef Saluja S, Anderson S, Hambleton I, Shoo H, Livingston M, Jude E, et al. Foot ulceration and its association with mortality in diabetes mellitus: a meta-analysis. Diabet Med. 2020;37(2):211–8.CrossRef
7.
go back to reference Brownrigg J, Davey J, Holt P, Davis W, Thompson M, Ray K, et al. The association of ulceration of the foot with cardiovascular and all-cause mortality in patients with diabetes: a meta-analysis. Diabetologia. 2012;55:2906–12. Brownrigg J, Davey J, Holt P, Davis W, Thompson M, Ray K, et al. The association of ulceration of the foot with cardiovascular and all-cause mortality in patients with diabetes: a meta-analysis. Diabetologia. 2012;55:2906–12.
8.
go back to reference De Berardis G, Pellegrini F, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, et al. Physician attitudes toward foot care education and foot examination and their correlation with patient practice. Diabetes Care. 2004;27(1):286–7.CrossRef De Berardis G, Pellegrini F, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, et al. Physician attitudes toward foot care education and foot examination and their correlation with patient practice. Diabetes Care. 2004;27(1):286–7.CrossRef
9.
go back to reference Sorber R, Abularrage CJ, editors. Diabetic foot ulcers: Epidemiology and the role of multidisciplinary care teams. Seminars in Vascular Surgery; 2021: Elsevier. Sorber R, Abularrage CJ, editors. Diabetic foot ulcers: Epidemiology and the role of multidisciplinary care teams. Seminars in Vascular Surgery; 2021: Elsevier.
10.
go back to reference Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM. Preventive foot care in diabetes. Diabetes Care. 2004;27:S63.CrossRef Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Pogach LM. Preventive foot care in diabetes. Diabetes Care. 2004;27:S63.CrossRef
11.
go back to reference Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31(8):1679–85.CrossRef Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31(8):1679–85.CrossRef
12.
go back to reference Bakker K, Apelqvist J, Schaper NC, Board IWGotDFE. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism research and reviews. 2012;28:225–31 Bakker K, Apelqvist J, Schaper NC, Board IWGotDFE. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes/metabolism research and reviews. 2012;28:225–31
13.
go back to reference Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, et al. Diabetic foot disorders: a clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45(5):S1–66.CrossRef Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, et al. Diabetic foot disorders: a clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45(5):S1–66.CrossRef
14.
go back to reference Sutton M, McGrath C, Brady L, Ward J. Diabetic foot care: assessing the impact of care on the whole patient. Practical Diabetes International. 2000;17(5):147–51.CrossRef Sutton M, McGrath C, Brady L, Ward J. Diabetic foot care: assessing the impact of care on the whole patient. Practical Diabetes International. 2000;17(5):147–51.CrossRef
15.
go back to reference Futrega K, King M, Lott WB, Doran MR. Treating the whole not the hole: necessary coupling of technologies for diabetic foot ulcer treatment. Trends Mol Med. 2014;20(3):137–42.CrossRef Futrega K, King M, Lott WB, Doran MR. Treating the whole not the hole: necessary coupling of technologies for diabetic foot ulcer treatment. Trends Mol Med. 2014;20(3):137–42.CrossRef
16.
go back to reference Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. JPMA The journal of the Pakistan Medical Association. 2009;59(10):687.PubMed Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. JPMA The journal of the Pakistan Medical Association. 2009;59(10):687.PubMed
17.
go back to reference Martini J. Diabetic foot: detection and prevention. La Revue de medecine interne. 2008;29:S260–3.CrossRef Martini J. Diabetic foot: detection and prevention. La Revue de medecine interne. 2008;29:S260–3.CrossRef
18.
go back to reference Polit DF. Essentials of nursing research: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. Polit DF. Essentials of nursing research: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010.
19.
go back to reference Kitzinger J. The methodology of focus groups: the importance of interaction between research participants. Sociol Health Illn. 1994;16(1):103–21.CrossRef Kitzinger J. The methodology of focus groups: the importance of interaction between research participants. Sociol Health Illn. 1994;16(1):103–21.CrossRef
20.
go back to reference Krueger RA. Focus groups: A practical guide for applied research: Sage publications; 1988. Krueger RA. Focus groups: A practical guide for applied research: Sage publications; 1988.
21.
go back to reference Kitzinger J. Qualitative research: introducing focus groups. BMJ. 1995;311(7000):299–302.CrossRef Kitzinger J. Qualitative research: introducing focus groups. BMJ. 1995;311(7000):299–302.CrossRef
22.
go back to reference Bryman A. Social research methods: Oxford university press; 2015. Bryman A. Social research methods: Oxford university press; 2015.
23.
go back to reference Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15.CrossRef Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15.CrossRef
24.
go back to reference Hsieh H, Shannon S.Three Approaches to Qualitative Content Analysis Qual Health Res 15: 1277-1288. SS.(2007). Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gyneco. 2005; (110): 330–9. Hsieh H, Shannon S.Three Approaches to Qualitative Content Analysis Qual Health Res 15: 1277-1288. SS.(2007). Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gyneco. 2005; (110): 330–9.
25.
go back to reference Krippendorff K. Content analysis: An introduction to its methodology: Sage publications; 2018. Krippendorff K. Content analysis: An introduction to its methodology: Sage publications; 2018.
26.
go back to reference Lincon YS, Guba EG. Naturalistic inquiry. Beverly Hills: Sage; 1985. Lincon YS, Guba EG. Naturalistic inquiry. Beverly Hills: Sage; 1985.
27.
go back to reference Guell C, Unwin N. Barriers to diabetic foot care in a developing country with a high incidence of diabetes related amputations: an exploratory qualitative interview study. BMC Health Serv Res. 2015;15(1):1–7.CrossRef Guell C, Unwin N. Barriers to diabetic foot care in a developing country with a high incidence of diabetes related amputations: an exploratory qualitative interview study. BMC Health Serv Res. 2015;15(1):1–7.CrossRef
28.
go back to reference Khan H, Lasker SS, Chowdhury TA. Exploring reasons for very poor glycaemic control in patients with type 2 diabetes. Prim Care Diabetes. 2011;5(4):251–5.CrossRef Khan H, Lasker SS, Chowdhury TA. Exploring reasons for very poor glycaemic control in patients with type 2 diabetes. Prim Care Diabetes. 2011;5(4):251–5.CrossRef
29.
go back to reference Sayampanathan AA, Cuttilan AN, Pearce CJ. Barriers and enablers to proper diabetic foot care amongst community dwellers in an Asian population: a qualitative study. Annals of translational medicine. 2017;5(12):254. Sayampanathan AA, Cuttilan AN, Pearce CJ. Barriers and enablers to proper diabetic foot care amongst community dwellers in an Asian population: a qualitative study. Annals of translational medicine. 2017;5(12):254.
30.
go back to reference Morschheuser B, Hassan L, Werder K, Hamari J. How to design gamification? A method for engineering gamified software. Inf Softw Technol. 2018;95:219–37.CrossRef Morschheuser B, Hassan L, Werder K, Hamari J. How to design gamification? A method for engineering gamified software. Inf Softw Technol. 2018;95:219–37.CrossRef
31.
go back to reference Fayfman M, Schechter MC, Amobi CN, Williams RN, Hillman JL, Alam MM, et al. Barriers to diabetic foot care in a disadvantaged population: A qualitative assessment. Journal of Diabetes and its Complications. 2020;34(12):107688 Fayfman M, Schechter MC, Amobi CN, Williams RN, Hillman JL, Alam MM, et al. Barriers to diabetic foot care in a disadvantaged population: A qualitative assessment. Journal of Diabetes and its Complications. 2020;34(12):107688
32.
go back to reference Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients’ and healthcare providers’ perspectives. J Clin Nurs. 2019;28(11–12):2296–308.CrossRef Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients’ and healthcare providers’ perspectives. J Clin Nurs. 2019;28(11–12):2296–308.CrossRef
Metadata
Title
Challenges and Expectations of Diabetic Foot Care from the Patients’ Point of Views
Authors
Maryam Aalaa
Neda Mehrdad
Shoaleh Bigdeli
Afsaneh Dehnad
Zohreh Sohrabi
Kamran Soltani Arabshahi
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Journal of Diabetes & Metabolic Disorders / Issue 2/2021
Electronic ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-021-00825-z

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