The interplay between patients with diabetic foot ulcer and healthcare professionals in a cross-sectorial setting addressing treatment and care; A realistic evaluation.

Abstract

Background Diabetes-related lower-extremity complications like diabetic foot ulcers (DFU) are a global disability burden. Thus, treatment and care for patients with DFU call for a multi-sectoral approach, incorporating interdisciplinary care pathways. We aimed to explore the interplay between patients with DFU and healthcare professionals in cross-sectorial settings addressing treatment and care. Method The study was designed as a realistic evaluation. Data was generated from September 2022 to marts 2023, drawing on approximately 60 hours of participant observation of 14 patients in their homes and at their outpatient clinic visits in Denmark. The Standards for Reporting Qualitative Research (SRQR) was applied in the paper. Results We identified three illuminating cumulations describing the interplay between the patients with DFU and healthcare professionals in the cross-sectorial setting: 1) Humor is a relationship-enhancing element between nurse and patient. 2) Support of the patient's coping strategies promotes patient-centeredness and collaboration. 3) Patients and professionals occupy unnegotiated identity roles. Conclusion In conclusion, this study provided insight into how the interplay between the patient and the healthcare professionals encourages the healthcare professionals’ agenda to promote health literacy and health promotion. The patient's and professionals' unnegotiated identity roles challenge collaboration, patient health literacy, and health promotion.