The patient's perspective of diabetic foot ulceration: A phenomenological exploration of causes, detection and care seeking.
Rebecca M Crocker, Tze-Woei Tan, Kelly N B Palmer and 1 others
PMID 35285035WHAT IT FOUND
Patients often did not know the term ulcer, calling problems blisters or cuts.
They noticed foot trouble through socks, shoes, pain, wetness or smell, then delayed care while managing pain, neuropathy, and heavy life demands.
Key findings
01Most participants did not use the medical term ulcer for their foot problems; they described them as blisters, callous, cuts, infections, injuries, wounds, or pain.
02Twelve of the 15 participants reported detecting the foot lesion themselves, often through pain, wetness or drainage on socks.
03Neuropathy dulled early detection, and participants often did not shift to urgent, clock-based care seeking until the problem worsened.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 15 interviews were analysed after 50 consented, so the findings reflect a small, high-burden sample and cannot be generalized. The sample was 10 men and 5 women, so men were overrepresented. Recruitment and interviews were disrupted by the pandemic, with months between consent and data collection. Two participants died before the study was completed, which may have affected the range of experiences reported. Participants came from a US tertiary referral center serving a local Hispanic and Native American population, limiting transferability to other settings. The research team included a clinician with established relationships with participants, and findings were prioritized within his clinical research framework, which may shape interpretation.
Declared interests
The authors declared no conflicts of interest. Funding is not reported in the supplied text.
The easy way to misread this
Do not read the delays as patient noncompliance. Participants often did not know what an ulcer was, could not feel or see early lesions because of neuropathy and reach limits, and faced long waits and fragmented care after they sought help.