The needs of patients with diabetes for the prevention and treatment of foot complications in Thailand: A qualitative descriptive study
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Keywords

diabetic foot
focus groups
nurses
patient needs
Thailand

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Kanan, P., Siribamrungwong, B., Tarawanich, T., Arapinth, S., & Napunnaphat, P. (2023). The needs of patients with diabetes for the prevention and treatment of foot complications in Thailand: A qualitative descriptive study. Belitung Nursing Journal, 9(6), 586–594. https://doi.org/10.33546/bnj.2835
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  • Thammasat University
    Grant numbers Faculty of Nursing, Thammasat University Research Fund, Contract No. 1/2562
Accepted for publication: 2023-11-25
Peer reviewed: Yes

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Abstract

Background: Inadequate diabetes self-management leads to foot infections and lower extremity amputations. Effective self-care, supported by nurse-provided information, is crucial, particularly in foot care. However, the current approach in Thailand focuses more on what nurses want patients to know rather than addressing patients’ actual needs. Consequently, nurses might misunderstand their patients' perspectives. Hence, nurses need to grasp patients’ needs for successful foot care behavior.

Objective: This study aimed to explore the needs of patients with diabetes regarding the prevention and treatment of foot complications.

Methods: The study employed a qualitative descriptive design. Thirty participants classified as high risk for foot ulcers were purposively selected from Thailand's university hospitals. Focus group discussions were used for data collection between June and July 2021. Verbatim transcription and content analysis were carried out for data analysis.

Results: Four emergent themes highlighted patients’ needs: 1) information-giving, 2) proactive foot screening with foot-care affirmation, 3) foot care services, and 4) relieving foot burdens and limb loss.

Conclusion: Nurses should change their mindset to care for and continually understand patients' needs. This involves adapting educational strategies like the teach-back method and coaching while providing skill training. Offering diverse service platforms, both online and onsite education programs and counseling, is essential. Additionally, ensuring accessibility and affordability, such as establishing after-hours clinics and supplying foot care toolkits, remains crucial.

https://doi.org/10.33546/bnj.2835
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Supporting Agencies

This research was supported by the Faculty of Nursing, Thammasat University Research Fund, Contract No. 1/2562.

Copyright

Copyright (c) 2023 Piyawan Kanan, Boonying Siribamrungwong, Thipapron Tarawanich, Saritpat Arapinth, Phunyada Napunnaphat

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declared that there is no conflict of interest.

Acknowledgment

The authors sincerely appreciated all the participants for the input they provided for this study.

Authors’ Contributions

Each author contributed equally to the conceptualization, design, data collection, and analysis. All authors contributed to the writing of the manuscript and approved the final draft. All authors met the ICMJE authorship criteria.

Data Availability

The data in this study are available from the corresponding author upon a reasonable request.

Declaration of Use of AI in Scientific Writing

Generative AI was not used in the writing process.


References

Aalaa, M., Sanjari, M., Shahbazi, S., Shayeganmehr, Z., Abooeirad, M., Amini, M. R., Adibi, H., & Mehrdad, N. (2017). Diabetic foot workshop: Improving technical and educational skills for nurses. Medical Journal of the Islamic Republic of Iran, 31, 8. https://doi.org/10.18869%2Fmjiri.31.8

Abbas, Z. G. (2017). Managing the diabetic foot in resource-poor settings: Challenges and solutions. Chronic Wound Care Management and Research, 4, 135-142. https://doi.org/10.2147/CWCMR.S98762

Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY, US: W H Freeman/Times Books/ Henry Holt & Co.

Begum, S., Venkatesan, M., & Ganapathy, K. (2019). Foot care practices, its barriers and risk for peripheral neuropathy among diabetic patients attending medical college in rural Puducherry. International Journal of Community Medicine and Public Health, 6(1), 203-207. https://doi.org/10.18203/2394-6040.ijcmph20185243

Birabwa, C., Bwambale, M. F., Waiswa, P., & Mayega, R. W. (2019). Quality and barriers of outpatient diabetes care in rural health facilities in Uganda–a mixed methods study. BMC Health Services Research, 19, 706. https://doi.org/10.1186/s12913-019-4535-x

Boonsatean, W., Carlsson, A., Dychawy Rosner, I., & Östman, M. (2018). Sex-related illness perception and self-management of a Thai type 2 diabetes population: A cross-sectional descriptive design. BMC Endocrine Disorders, 18(5). https://doi.org/10.1186/s12902-017-0229-8

Bus, S. A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Raspovic, A., Sacco, I. C. N., van Netten, J. J., & International Working Group on the Diabetic, F. (2020). Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews, 36, e3269. https://doi.org/10.1002/dmrr.3269

Corbett, C., Jolley, J., Barson, E., Wraight, P., Perrin, B., & Fisher, C. (2019). Cognition and understanding of neuropathy of inpatients admitted to a specialized tertiary diabetic foot unit with diabetes-related foot ulcers. The International Journal of Lower Extremity Wounds, 18(3), 294-300. https://doi.org/10.1177/1534734619862085

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Cusi, K., Das, S. R., & Gibbons, C. H. (2023a). Summary of revisions: Standards of Care in Diabetes—2023. Diabetes Care, 46(Supplement_1), S5-S9. https://doi.org/10.2337/dc23-Srev

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Cusi, K., Hilliard, M. E., & Isaacs, D. (2023b). Comprehensive medical evaluation and assessment of comorbidities: Standards of Care in Diabetes—2023. Diabetes Care, 46(Supplement_1), s49-s67. https://doi.org/10.2337/dc23-S004

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., & Johnson, E. L. (2023c). Facilitating positive health behaviors and well-being to improve health outcomes: Standards of Care in Diabetes—2023. Diabetes Care, 46(Supplement_1), S68-S96. https://doi.org/10.2337/dc23-S005

Guell, C., & Unwin, N. (2015). Barriers to diabetic foot care in a developing country with a high incidence of diabetes related amputations: An exploratory qualitative interview study. BMC Health Services Research, 15, 377. https://doi.org/10.1186/s12913-015-1043-5

International Diabetes Federation. (2017). IDF 2017 diabetes atlas. https://diabetesatlas.org/atlas/eighth-edition/

International Diabetes Federation. (2021). IDF 2021 diabetes atlas. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf

INTRAC. (2017). Focus group discussions. https://www.intrac.org/wpcms/wp-content/uploads/2017/01/Focus-group-discussions.pdf

Kanan, P., Piaseu, N., Malathum, P., & Belza, B. (2018). Social network and social support for diabetes self-management in older people with diabetes with poorly controlled: A mixed method study [Doctoral Dissertation, Mahidol University]. Bangkok, Thailand.

Kanan, P., Siribumrungwong, B., Tharawanit, T., Arapin, S., & Napanpat, P. (2021). The perceptions of healthcare professionals toward clinical practice guideline prevention and management of diabetic foot complications B.E. 2556 and the patient’s needs: mixed method research [Unpublished report]. Pathumtani, Thailand.

Kaya, Z., & Karaca, A. (2018). Evaluation of nurses’ knowledge levels of diabetic foot care management. Nursing Research and Practice, 2018, 8549567. https://doi.org/10.1155/2018/8549567

Kirk, B. O., Khan, R., Davidov, D., Sambamoorthi, U., & Misra, R. (2023). Exploring facilitators and barriers to patient-provider communication regarding diabetes self-management. PEC Innovation, 3, 100188. https://doi.org/10.1016/j.pecinn.2023.100188

Koetsenruijter, J., van Eikelenboom, N., van Lieshout, J., Vassilev, I., Lionis, C., Todorova, E., Portillo, M. C., Foss, C., Gil, M. S., & Roukova, P. (2016). Social support and self-management capabilities in diabetes patients: An international observational study. Patient Education and Counseling, 99(4), 638-643. https://doi.org/10.1016/j.pec.2015.10.029

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. California: Sage Publications.

Merighi, M. A. B., Oliveira, D. M. d., Jesus, M. C. P. d., Souto, R. Q., & Thamada, A. A. (2013). Mulheres idosas: desvelando suas vivências e necessidades de cuidado [Elderly women: Revealing their experiences and care needs]. Revista da Escola de Enfermagem da USP, 47(2), 408–414. https://doi.org/10.1590/S0080-62342013000200019

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks: Sage.

Monami, M., Zannoni, S., Gaias, M., Nreu, B., Marchionni, N., & Mannucci, E. (2015). Effects of a short educational program for the prevention of foot ulcers in high-risk patients: A randomized controlled trial. International Journal of Endocrinology, 2015, 615680. https://doi.org/10.1155/2015/615680

Nang, E. E. K., Dary, C., Hsu, L. Y., Sor, S., Saphonn, V., & Evdokimov, K. (2019). Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: A qualitative study. BMJ Open, 9(11), e032578. http://dx.doi.org/10.1136/bmjopen-2019-032578

Papaspurou, M., Laschou, V. C., Partsiopoulou, P., Fradelos, E. C., Kleisiaris, C. F., Kalota, M. A., Neroliatsiou, A., & Papathanasiou, I. V. (2015). Fears and health needs of patients with diabetes: A qualitative research in rural population. Medical Archives, 69(3), 190-195.

Patel, P., Speight, C., Maida, A., Loustalot, F., Giles, D., Phiri, S., Gupta, S., & Raghunathan, P. (2018). Integrating HIV and hypertension management in low-resource settings: Lessons from Malawi. PLoS Medicine, 15(3), e1002523. https://doi.org/10.1371/journal.pmed.1002523

Peimani, M., Nasli-Esfahani, E., Stewart, A. L., Shakibazadeh, E., Yekaninejad, M. S., & Garmaroudi, G. (2020). Patient-physician communication in the context of diabetes care: Adaptation and assessment of psychometric properties of a Persian version of the interpersonal process of care survey (P-IPC). Diabetes Research and Clinical Practice, 162, 108109. https://doi.org/10.1016/j.diabres.2020.108109

Pereira, M. G., Pedras, S., & Ferreira, G. (2019). Self-reported adherence to foot care in type 2 diabetes patients: Do illness representations and distress matter? Primary Health Care Research & Development, 20, e40. https://doi.org/10.1017/S1463423618000531

Polonsky, W. H., Capehorn, M., Belton, A., Down, S., Gamerman, V., Nagel, F., Lee, J., & Edelman, S. (2017). Physician–patient communication at diagnosis of type 2 diabetes and its links to patient outcomes: New results from the global IntroDia® study. Diabetes Research and Clinical Practice, 127, 265-274. https://doi.org/10.1016/j.diabres.2017.03.016

Pourkazemi, A., Ghanbari, A., Khojamli, M., Balo, H., Hemmati, H., Jafaryparvar, Z., & Motamed, B. (2020). Diabetic foot care: Knowledge and practice. BMC Endocrine Disorders, 20, 1-8. https://doi.org/10.1186/s12902-020-0512-y

Quandt, S. A., Reynolds, T., Chapman, C., Bell, R. A., Grzywacz, J. G., Ip, E. H., Kirk, J. K., & Arcury, T. A. (2013). Older adults’ fears about diabetes: using common sense models of disease to understand fear origins and implications for self-management. Journal of Applied Gerontology, 32(7), 783-803. https://doi.org/10.1177/0733464811435506

Ramkisson, S., Pillay, B. J., & Sibanda, W. (2017). Social support and coping in adults with type 2 diabetes. African Journal of Primary Health Care and Family Medicine, 9(1), a1405. https://doi.org/10.4102/phcfm.v9i1.1405

Reeve, B. B., Thissen, D. M., Bann, C. M., Mack, N., Treiman, K., Sanoff, H. K., Roach, N., Magnus, B. E., He, J., & Wagner, L. K. (2017). Psychometric evaluation and design of patient-centered communication measures for cancer care settings. Patient Education and Counseling, 100(7), 1322-1328. https://doi.org/10.1016/j.pec.2017.02.011

Ryan, P., & Sawin, K. J. (2009). The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook, 57(4), 217-225. https://doi.org/10.1016/j.outlook.2008.10.004

Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334-340. https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G

Street Jr, R. L., & Mazor, K. M. (2017). Clinician–patient communication measures: Drilling down into assumptions, approaches, and analyses. Patient Education and Counseling, 100(8), 1612-1618. https://doi.org/10.1016/j.pec.2017.03.021

Teddlie, C., & Yu, F. (2007). Mixed methods sampling: A typology with examples. Journal of Mixed Methods Research, 1(1), 77-100. https://doi.org/10.1177/1558689806292430

Thai Ministry of Public Health. (2023). Clinical practice guideline for diabetes 2023. https://drive.google.com/file/d/1OAIDiCyGsJYA1-wTAxoOu6yL_YL9c7IG/view?pli=1

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357.

Ugwu, E., Onung, S., Ezeani, I., Olamoyegun, M., Olufunmilayo, A., & Uloko, A. (2020). Barriers to diabetes care in a developing country: Exploratory evidence from diabetes healthcare providers. Journal of Advances in Medicine and Medical Research, 32(10), 72-83. https://doi.org/10.9734/jammr/2020/v32i1030522

White, R. O., Eden, S., Wallston, K. A., Kripalani, S., Barto, S., Shintani, A., & Rothman, R. L. (2015). Health communication, self-care, and treatment satisfaction among low-income diabetes patients in a public health setting. Patient Education and Counseling, 98(2), 144-149. https://doi.org/10.1016/j.pec.2014.10.019


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