Perceptions of healthcare professionals on the management of diabetic foot disease in Oman: a qualitative COM-B framework analysis.

AIMS: Diabetic foot disease (DFD) is a leading cause of amputation and preventable morbidity among persons with diabetes. This study explored healthcare professionals' (HCPs) perceptions of DFD management in Oman, examining access to diabetic foot care (DFC), quality of care, service challenges, and improvement recommendations.

METHODS

Four focus group discussions were conducted in February 2025 with 35 HCPs: podiatrists (10), followed by nurses (9), physicians (including endocrinologist) (10), and surgeons (6). Sessions were audio-recorded, transcribed, and analysed using hybrid thematic analysis within an Interpretative Phenomenological Analysis framework. Themes were mapped onto the COM-B (Capability, Opportunity, Motivation-Behaviour) framework.

RESULTS

Participants (mean age 39 years [SD 5]; 82.9% female; mean experience 12.4 years [SD 6]) identified five principal barriers: regional access disparities, poor DFC integration into primary care, absent quality indicators, fragmented specialist services, and cultural misconceptions favouring traditional remedies. Recommendations included expanded screening, personalised care plans, multidisciplinary collaboration, telemedicine, and advanced wound care. Application of the COM-B framework to the emergent themes provides a multilayered strategy to advance DFC through targeted policy, educational, and structural interventions.

CONCLUSIONS

A national coordinating governance structure for DFD is urgently recommended.