A qualitative study exploring and understanding the experiences and unmet needs of adults with type 2 diabetes and diabetes-related foot ulcers.

AIMS: Diabetes-related foot ulcers (DFUs) are associated with depression, impaired health-related quality of life, an increased risk of cardiovascular disease and early mortality. To inform holistic care pathways, this qualitative study explored the experiences and unmet needs of adults living with type 2 diabetes mellitus (T2DM) and DFUs.

METHODS

Semi-structured interviews were conducted with 25 adults with T2DM and current or previous DFUs, and 20 healthcare professionals with experience treating DFUs. Topic guides were underpinned by the Theoretical Domains Framework. Data were analysed using reflexive thematic analysis.

RESULTS

Four themes and three sub-themes were created relating to the impact of DFUs. DFUs were perceived as a 'wake-up call'; the experience often came as a shock, prompting individuals to consider what was responsible for their development. DFUs impacted individuals' behaviours in multiple ways: for some, they were a catalyst for positive change; for others, they fostered behaviours that were unhealthful and/or discordant with professionals' advice. DFUs negatively affected the physical and psychosocial well-being of individuals with DFU; sedentary behaviours instigated by DFUs led to changes in mood and mental health, in addition to increased weight, mobility problems and an amplified risk of health complications. Regarding the unmet needs of people with T2DM and DFUs, three themes were developed, capturing the need for treatment plans created through shared decision making and improving access to physical well-being and psychological support.

CONCLUSIONS

These findings identify several important areas of unmet need regarding care for adults with T2DM and DFUs, which can help inform improved support for this population.