Healing Steps on Country-Exploring Care Pathways for Aboriginal People in the Kimberley With Diabetes-Related Foot Disease.
Sophie Moustaka, Ala Mckay, Ellen Stapleton and 5 others
PMID 41928458WHAT IT FOUND
Remote Aboriginal patients with diabetes foot disease had many acute foot-care visits and hospital admissions, but little preventive care.
They valued local Aboriginal health services, support people, and self-care, while hospital discharge left some under-informed and under-equipped.
Key findings
013303 primary care and outpatient presentations were identified, with a median of 57 presentations per participant.
02Only 10 of 35 participants had preventive foot care before their first DFD presentation, and 306 of 3303 foot-care attendances were preventive.
03Participants valued local ACCHS foot care and wanted more opportunity to care for their own wounds.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
Only 35 patients consented to file review, and 28 consented to interviews, so the findings are descriptive and may not represent all Aboriginal people with DFD in the Kimberley. Records came from ACCHS primary care, so hospital outpatient care and care from other providers were likely underestimated. Recruitment was through patients presenting to services, which may have favoured people with more severe DFD or better engagement. Diabetes educator and dietician consultations were not recorded, so the volume and diversity of care may be undercounted. No data were collected from patients who declined, so representativeness cannot be checked. The automated DFD attendance report captured only 9.8% of file-reviewed presentations and was not useful for monitoring trends. The study did not test whether self-care, telehealth, support persons or discharge changes improve outcomes.
Declared interests
No specific grant funded the work. The authors reported nothing to disclose, but some authors worked for local podiatry services and provided care to participants, and another author worked for Kimberley Renal Services and provided renal care.
The easy way to misread this
Do not read the themes as evidence that self-care, telehealth or support persons improve diabetes foot outcomes. The study describes patients' experiences and service use in 35 people, without a control group or tested intervention.