Patients' perspectives on foot complications in type 2 diabetes: a qualitative study. 2008

Lone Gale, and Kavita Vedhara, and Aidan Searle, and Terry Kemple, and Rona Campbell
Department of Social Medicine, University of Bristol, Horfield Health Centre, Bristol. Lone.Gale@bristol.ac.uk

BACKGROUND Foot ulceration is a major health problem for people with diabetes. To minimise the risk of ulceration, patients are advised to perform preventive foot self-care. OBJECTIVE To explore beliefs about diabetic foot complications and everyday foot self-care practices among people with type 2 diabetes. METHODS Qualitative study using one-to-one interviews. METHODS A suburban primary care health centre. METHODS Semi-structured interviews with a purposive sample of adults with type 2 diabetes but with no experience of foot ulceration. RESULTS Most participants were unsure of what a foot ulcer is and unaware of the difficulties associated with ulcer healing. Prevention of accidental damage to the skin was not considered a priority, as few participants knew that this is a common cause of foot ulceration. Although it was recognised that lower-limb amputation is more common in people with diabetes, this was perceived to be predominantly caused by poor blood supply to the feet and unrelated to foot ulceration. Therefore, preventive foot care focused on stimulating blood circulation, for example by walking barefoot. Consequently, some of the behaviours participants considered beneficial for foot health could potentially increase the risk of ulceration. In some cases the uptake of advice regarding preventive foot care was hampered because participants found it difficult to communicate with health professionals. CONCLUSIONS Patients with type 2 diabetes may have beliefs about foot complications that differ from medical evidence. Such illness beliefs may play a role in foot-related behaviours that have previously been unrecognised. Health professionals need to explore and address the beliefs underlying patients' foot self-care practices.

UI MeSH Term Description Entries
D008019 Life Style Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed) Lifestyle Factors,Life Style Induced Illness,Lifestyle,Factor, Lifestyle,Life Styles,Lifestyle Factor,Lifestyles
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010353 Patient Education as Topic The teaching or training of patients concerning their own health needs. Education of Patients,Education, Patient,Patient Education
D003924 Diabetes Mellitus, Type 2 A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY. Diabetes Mellitus, Adult-Onset,Diabetes Mellitus, Ketosis-Resistant,Diabetes Mellitus, Maturity-Onset,Diabetes Mellitus, Non-Insulin-Dependent,Diabetes Mellitus, Slow-Onset,Diabetes Mellitus, Stable,MODY,Maturity-Onset Diabetes Mellitus,NIDDM,Diabetes Mellitus, Non Insulin Dependent,Diabetes Mellitus, Noninsulin Dependent,Diabetes Mellitus, Noninsulin-Dependent,Diabetes Mellitus, Type II,Maturity-Onset Diabetes,Noninsulin-Dependent Diabetes Mellitus,Type 2 Diabetes,Type 2 Diabetes Mellitus,Adult-Onset Diabetes Mellitus,Diabetes Mellitus, Adult Onset,Diabetes Mellitus, Ketosis Resistant,Diabetes Mellitus, Maturity Onset,Diabetes Mellitus, Slow Onset,Diabetes, Maturity-Onset,Diabetes, Type 2,Ketosis-Resistant Diabetes Mellitus,Maturity Onset Diabetes,Maturity Onset Diabetes Mellitus,Non-Insulin-Dependent Diabetes Mellitus,Noninsulin Dependent Diabetes Mellitus,Slow-Onset Diabetes Mellitus,Stable Diabetes Mellitus
D005194 Family Practice A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. Family Practices,Practice, Family,Practices, Family
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000671 Amputation, Surgical The surgical removal of part of, or all of, a limb or other appendage or outgrowth of the body. Amputation,Amputation, Multiple, Surgical,Multiple Amputation, Surgical,Surgical Amputation Procedures,Amputation Procedure, Surgical,Amputation Procedures, Surgical,Amputation, Surgical Multiple,Amputations,Amputations, Surgical,Amputations, Surgical Multiple,Multiple Amputations, Surgical,Procedure, Surgical Amputation,Procedures, Surgical Amputation,Surgical Amputation,Surgical Amputation Procedure,Surgical Amputations,Surgical Multiple Amputation,Surgical Multiple Amputations

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