A Phenomenological Study of Primary Healthcare Nurses' Experiences in Assessing and Managing Diabetic Foot Complications.

BACKGROUND

In South Africa, diabetic foot complications (DFC) often present for the first time at the primary healthcare (PHC) level, where nurses are central to diabetes management and prevention. Despite their key role, there are limited data on nurses' experiences in managing DFC, particularly in resource-constrained primary healthcare (PHC) settings. This study's objective was to explore and describe nurses' experiences in managing DFC at the PHC level, with the aim of informing future interventions and policy development.

METHODS

A descriptive phenomenological study was conducted with 21 PHC nurses working in community healthcare centres to explore their experiences in managing DFC within PHC facilities.

RESULTS

Five key themes emerged: limited knowledge, time and workload constraints, lack of referral feedback, need for targeted training, and resource constraints. These reflect systemic and practical barriers that hinder effective care and contribute to inconsistent patient outcomes. Nurses are vital to early detection and intervention but face structural challenges that limit their capacity to deliver optimal care.

CONCLUSIONS

Nurses encounter significant challenges when implementing routine diabetic foot screening at the primary healthcare level. These challenges include limited training, inadequate resources, and poor interprofessional collaboration. To overcome these barriers, targeted capacity-building initiatives, improved referral and communication pathways, and the provision of essential tools and support are needed. Additionally, integrating podiatrists into primary healthcare teams and establishing multidisciplinary foot care services are crucial steps to enhance care quality and reduce complications in resource-limited settings.