Experiences of living with, managing, and preventing reoccurrence of Diabetic Foot Ulcers: Restoring context and complexity to health and illness research.

Diabetes is a major global health concern, with diabetic foot ulcers (DFUs) presenting a common complication. Interest is growing in people's lived experiences of DFUs, including their management and prevention. Typically, research has highlighted the disruptive and extended impact of DFUs, and has focused on the role of intrinsic, individual factors (e.g. knowledge, physical capabilities and personal choices) in their development and management. The influence of extrinsic, contextual factors, has received comparatively limited attention. To address this potentially important gap in the literature we set out to explore people's experiences of DFUs, using a distinctive, contextually-sensitive, analytical lens. Our analysis led us to identify three over-arching themes: a spectrum of embodied experiences of DFUs; intersection with wider experiences of ill-health; and, framing of (DFU) experiences by broader life circumstances. Within these themes, considerable diversity was evident. Broader life circumstances, in particular, shaped experiences of living with, managing, and preventing reoccurrence of DFUs in markedly different, and previously unacknowledged, ways. We conclude that experiences of DFUs are far more nuanced and contextually-mediated than previously reported, and identify important practical implications for the provision of sensitive and effective support and clinical care. Moreover, we suggest that identifying these sorts of complexities in illness experiences may require larger, and more varied samples and data-sets than have become the norm in qualitative health research, as well as more expansive disciplinary lenses.