Foot Self Care Practices Among Patients With Type 2 Diabetes And Diabetic Foot Ulcers

Background: Diabetic foot ulcers (DFUs) are a major cause of morbidity and mortality globally. DFUs are often marked by poor healing, infection, re-ulceration, prolonged hospitalization, impaired quality of life, and death. Approximately 80,000 Americans lose their toes to DFU-related amputations annually, leading to impaired quality of life and financial burden. Research supports prevention of DFUs through foot self-care practices. However, a gap exists between healthcare provider recommendations and actions taken by patients with DFUs. This study explored the lived experiences of patients with type 2 diabetes and DFUs regarding their foot self-care practices. The long-term goal of this research is to support the development and delivery of patient-centered interventions to prevent DFUs and re-ulceration.Method: A descriptive phenomenological research study was conducted with a purposive sample of adults with type 2 diabetes and DFUs. Fifteen participants were recruited and interviewed from outpatient podiatry clinics in Washington State. Data were analyzed using Colaizzi's approach to phenomenology.Findings: Participants reported initially being passive about foot self-care. This was impacted by a lack of awareness between diabetes, foot self-care and DFU development. However, the sudden onset of DFUs was a wake-up call to adapt to a new reality. Adaptation included monitoring their feet, performing foot self-care, and learning about their disease process. However, ongoing challenges with DFUs and foot self-care continue to impair participants' physical, social, and mental well-being. Some participants seek self-management strategies in a quest to make their feet comfortable and continue with their preferred lifestyle.Conclusion: This research provides a rich description of the lived experience of patients with type 2 diabetes and DFUs. Findings provide broad insights into participants' perception of foot self-care practices. Evidence from this study supports that the risk perception of patients with diabetes impacted their health behaviors. Early education to promote health literacy is important to help patients with type 2 diabetes understand their susceptibility to DFUs and the severity of DFUs. Tailored and long-term behavioral reinforcement may support daily foot self-care and ongoing challenges with DFU to reduce DFU development and re-ulceration.