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. 2023 Aug;31(4):690-703.
doi: 10.1111/ajr.12989. Epub 2023 Apr 24.

Perceptions of Australians with diabetes-related foot disease on requirements for effective secondary prevention

Aaron Drovandi  1   2 , Benjamin Crowley  1 , Chanika Alahakoon  1 , Leonard Seng  1 , Malindu E Fernando  1   3   4   5 , Diane Ross  6 , Rebecca Evans  1 , Jonathan Golledge  1   3   7
Affiliations

Perceptions of Australians with diabetes-related foot disease on requirements for effective secondary prevention

Aaron Drovandi et al. Aust J Rural Health. 2023 Aug.

Abstract

Introduction: Secondary prevention is essential in reducing recurrence of diabetes-related foot disease (DFD) but is frequently poorly implemented in clinical practice.

Objective: To explore the perceptions of people with diabetes-related foot disease (DFD) on their self-perceived knowledge in managing DFD, facilitators and barriers influencing their DFD care, and ideas and preferences for a secondary prevention program.

Design: Sixteen people with a history of DFD from Queensland and Victoria, Australia, underwent semi-structured interviews. Interviews were audio-recorded over telephone and transcribed and analysed following a thematic framework. Participants were asked about their experiences and perceptions relating to DFD and factors influencing the care they receive for DFD relevant to the development of a secondary prevention program for DFD.

Findings and discussion: Participants had high self-perceived knowledge in managing DFD, especially in implementing healthy lifestyle changes and conducting daily foot checks and foot care, though most received support from family members acting as carers. However, issues with access and adherence to offloading footwear, and a lack of clear education received on footwear and other aspects of DFD care were perceived as major barriers. Improved patient education, provided in a consistent manner by proactive clinicians was perceived as an essential part of secondary prevention. Telehealth was perceived positively through facilitating faster care and considered a good adjunct to standard care. Health and technological literacy were considered potentially major barriers to the effectiveness of remote care.

Conclusion: People with DFD require improved access to offloading footwear and education about secondary prevention, which could be provided by telehealth with adequate support.

Keywords: diabetes; offloading footwear; patient education; peripheral artery disease; qualitative research; secondary care; telehealth.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Aligning of subthemes identified with the six components of the Health Belief Model (HBM).
FIGURE 2
FIGURE 2
Key themes identified relating to factors impacting on participant foot care in the home environment.
FIGURE 3
FIGURE 3
Key themes identified relating to the facilitators and barriers of DFD management.
FIGURE 4
FIGURE 4
Key themes identified relating to the development of a secondary prevention program for DFD.
See this image and copyright information in PMC

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