Exploring barriers and enablers of self‐management behaviours in patients with diabetic foot ulcers: A qualitative study from the perceptions of patients, caregivers, and healthcare professionals in primary care

Zhu, Xiaoli; Lee, Eng Sing; Lim, Phoebe X. H.; Chen, Yee Chui; Chan, Frank; Griva, Konstadina

doi:10.1111/iwj.14153

Cited by 6 publications

(4 citation statements)

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“…The SEM results showed a direct positive relationship between threat perceptions and diabetic foot self‐care behaviour. This finding accords with our recent qualitative work, which identified low perceived threat (i.e., illness consequence) as a barrier to DFU foot self‐management 45 . This finding suggests that threat perceptions may not necessarily be maladaptive in the context of self‐care but may instead activate patients to take actions to prevent and manage their foot ulcers.…”

Section: Discussionsupporting

confidence: 89%

Foot self‐care behaviour in primary care patients with diabetic foot ulcers: Structural equation modelling of psychological predictors

Zhu,

Lee,

Chan

et al. 2024

International Wound Journal

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Diabetic foot ulcers (DFUs) are one of the most prevalent and costly diabetes complications, associated with diminished quality of life and poor prognosis. Management of DFUs relies heavily on patients' foot self‐care behaviour. This study aims to explore psychological determinants of this important behaviour among primary care patients. A total of 186 patients with active DFUs self‐reported their illness perception, diabetes distress, self‐efficacy, and foot self‐care behaviour. Structural equation modelling was performed to examine interrelationships among measured variables. The final model demonstrated satisfactory fit, CFI = 0.933, TLI = 0.913, RMSEA = 0.050, SRMR = 0.073, χ2(95) = 132.256 (p = 0.004), and explained 51.1% of the variance of foot self‐care. Illness threat perceptions (i.e., consequence, timeline, identity, concern, and emotion) had a direct positive effect on foot self‐care behaviours, but also indirectly decreased foot self‐care through increasing diabetes distress. Control perceptions (i.e., personal control, treatment control, and coherence) were not directly associated with foot self‐care behaviours, but indirectly improved foot self‐care by reducing diabetes distress and increasing foot care confidence. These findings suggest illness perceptions, diabetes distress, and self‐care confidence as modifiable predictors to be targeted in self‐management interventions for patients with DFUs.

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Section: Discussionsupporting

confidence: 89%

Foot self‐care behaviour in primary care patients with diabetic foot ulcers: Structural equation modelling of psychological predictors

Zhu,

Lee,

Chan

et al. 2024

International Wound Journal

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“…Family Adaptability and Cohesion Evaluation Scale (FACESII-CV) 47 : This scale was developed by Olsen 48 (2,4,6,8 ,10,12,14,16,18,20,22,24,26,28). Each entry is rated on a 5-level scale: 1-no, 2-occasionally, 3-sometimes, 4often, 5-always, where items (3,9,19,24,28,29) are negative integrals, other items are integrated positively, and the response to each item represents the degree to which the condition described in the item occurs in the family, the higher the score, the better the family closeness and adaptability. The Cronbach's α of family closeness is 0.85, and the Cronbach's α of family adaptability is 0.73.…”

Section: Study Instrumentsmentioning

confidence: 99%

“…17 Good information quality effectively improves the quality of life and mental health in patients with chronic heart failure. 18 Qualitative study 19 suggests that people with diabetes with sufficient health information still have low levels of self-management due to a lack of perceived usefulness. Moreover, it positively affects anxiety, depression and compliance behaviour of patients with diabetes complications.…”

Section: Introductionmentioning

confidence: 99%

Exploring the relationship between self-management behaviour, family function and health information adoption behaviour in Chinese diabetic foot patients: a mixed-methods study protocol

Wang,

Tang,

et al. 2023

BMJ Open

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IntroductionDiabetic foot is a major burden and threat to individuals, families and society, making it imperative to promote good self-management behaviour. However, although nurses have provided these patients with excellent health knowledge, their self-management remains unsatisfactory. Although researches have shown that self-management requires family involvement, no research has been conducted in China on family function, specifically in the diabetic foot. Therefore, this study aimed to explore the relationship between self-management, family functioning, and health information adoption behaviour and explain the formation’s reason.Method and analysisWe will conduct a mixed-methods study using an exploratory sequential study design in Zhejiang, China. In the first phase, cross-section research will be conducted using a convenient sampling strategy on 225 diabetic foot patients. SPSS V.26 was used for correlation and multiple stepwise regression analyses. Structural equation modelling will be performed by using AMOS V.24. The researchers will conduct a semistructured interview to collect qualitative data and use NVivo to analyse. Ultimately, we will ‘triangulate’ to integrate quantitative and qualitative data.Ethics and disseminationThis study received ethical clearance from the Ethics Review Committee, the affiliated Sir Run Run Shaw Hospital of Medicine School, Zhejiang University (approval no: 2023-0145). All data collection processes will abide by health and safety measures required by the national government. Written informed consent will be obtained from all participants. The study will produce one paper that will be disseminated, to local stakeholders and participants, via local and international conferences and publications in peer-reviewed journals.

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“…The treatment of DF is complex, taking months or years to heal, and the recurrence rate remains high at up to 40% within 1 year after healing. In addition, DF is the cause of up to 85% of patients with diabetes who subsequently undergo lower limb amputations and is the leading cause of disability worldwide (Zhu et al, 2023). DF can lead to an increase in hospital expenditures, emergency room admission, extended hospital stay, unemployment, depression, lack of independence, and disability, as well as an increase in mortality rates, which has brought a heavy burden to patients as well as public health systems (Costa et al, 2020; Jiang et al, 2022; Zhou et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Relationship between illness perception and self‐management behaviors among Chinese diabetic foot patients

Xiong

Zhang

et al. 2023

Japan Journal Nursing Sci

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AimThe aims of the present study are to describe the status of self‐management behaviors and illness perception, and explore the relationship between illness perception and self‐management behaviors among Chinese diabetic foot patients.MethodsA cross‐sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self‐management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis.ResultsOnly 3.2% of participants maintained excellent self‐management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self‐management behaviors.ConclusionsPatient illness perception is an important factor influencing self‐management behaviors. It may be helpful to improve self‐management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions.

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Exploring barriers and enablers of self‐management behaviours in patients with diabetic foot ulcers: A qualitative study from the perceptions of patients, caregivers, and healthcare professionals in primary care

Cited by 6 publications

References 74 publications

Foot self‐care behaviour in primary care patients with diabetic foot ulcers: Structural equation modelling of psychological predictors

Foot self‐care behaviour in primary care patients with diabetic foot ulcers: Structural equation modelling of psychological predictors

Exploring the relationship between self-management behaviour, family function and health information adoption behaviour in Chinese diabetic foot patients: a mixed-methods study protocol

Relationship between illness perception and self‐management behaviors among Chinese diabetic foot patients

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