Title : A qualitative study on barriers to self management among patients with diabetic foot from the perspective of illness experience: In depth interviews with patients, caregivers and healthcare providers
Abstract:
Background: Diabetic foot is a serious complication of diabetes mellitus, and effective self?management is critical to prevent ulceration and amputation. Most existing studies explore self?management barriers only from patient’s perspective, while few studies incorporate viewpoints of caregivers and healthcare providers. From the illness?experience perspective, this study aimed to identify multi?level barriers of self?management for diabetic foot patient's based on tripartite interviews.
Methods: A qualitative phenomenological study was conducted. Purposive sampling was adopted to recruit diabetic foot patients, primary family caregivers and clinical healthcare providers. Semi?structured in?depth interviews were performed. Colaizz is seven?step analysis was used for data analysis until data saturation was achieved.
Results: Three main themes were extracted.
? Individual barriers: Insufficient disease risk perception, physical pain, psychological burnout and economic burden restricted patient’s self?management.
? Family?related barriers: Caregivers lacked professional knowledge, suffered care?giving burnout, and family support varied among participants.
? Healthcare?system barriers: Fragmented in?hospital health education, insufficient post?discharge continuous guidance, and theoretical content mismatched real?life family situations.
Conclusion: Barriers to diabetic foot self?management originate from individual, family and healthcare dimensions. Single?patient?oriented education is limited. Comprehensive strategies targeting patients, caregivers and post?discharge care are required. The findings can provide real?world evidence for developing self?management intervention programs.
