Adherence to limiting weight-bearing activity in patients with diabetic foot ulcers: A qualitative study

Hancox, Jennie E.; Hilton, Charlotte; Gray, Katie; Game, Fran; Vedhara, Kavita

Abstract

Patients with diabetic foot ulcers are advised to limit weight-bearing activity for ulcers to heal. Patients often disregard this advice although the reasons are not yet fully understood. This study explored (1) patients' experiences of receiving the advice and (2) factors influencing adherence to the advice. Semi-structured interviews were conducted with 14 patients with diabetic foot ulcers. Interviews were transcribed and analysed using inductive thematic analysis. Advice regarding limiting weight-bearing activity was described by patients as directive, generic and conflicting with other priorities. Rapport, empathy and rationale supported receptivity to the advice. Barriers and facilitators to limiting weight-bearing activity included demands of daily living, enjoyment of exercise, sick/disabled identity and burden, depression, neuropathy/pain, health benefits, fear of negative consequences, positive feedback, practical support, weather and active/passive role in recovery. It is important that healthcare professionals pay attention to how limiting weight-bearing activity advice is communicated. We propose a more person-centred approach in which advice is tailored to individuals' specific needs with discussion around patient priorities and constraints.

Citation

Hancox, J. E., Hilton, C., Gray, K., Game, F., & Vedhara, K. (2023). Adherence to limiting weight-bearing activity in patients with diabetic foot ulcers: A qualitative study. International Wound Journal, https://doi.org/10.1111/iwj.14282

• Journal Article Type: Article
• Acceptance Date: Jun 1, 2023
• Online Publication Date: Jun 13, 2023
• Publication Date: Jun 13, 2023
• Deposit Date: Jun 2, 2023
• Publicly Available Date: Jun 2, 2023
• Journal: International Wound Journal
• Print ISSN: 1742-4801
• Electronic ISSN: 1742-481X
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/iwj.14282
• Keywords: Patient adherence, motivation, diabetic foot ulcer, communication, physician-patient relations
• Public URL: https://nottingham-repository.worktribe.com/output/21375505
• Publisher URL: https://onlinelibrary.wiley.com/journal/1742481x