Reducing the burden of chronic wounds: prevention and management of the diabetic foot in the context of clinical guidelines
Objectives: Chronic wounds such as diabetic foot and venous leg ulcers are a major burden for health services. Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses o...
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| Veröffentlicht in: | Journal of health services research & policy 2008-10, Vol.13 (3_suppl), p.82-91 |
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| container_title | Journal of health services research & policy |
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| creator | Searle, Aidan Gale, Lone Campbell, Rona Wetherell, Mark Dawe, Karen Drake, Nikki Dayan, Colin Tarlton, John Miles, Jeremy Vedhara, Kavita |
| description | Objectives: Chronic wounds such as diabetic foot and venous leg ulcers are a major burden for health services. Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses on two particular aspects of the programme: patient knowledge of diabetic foot ulceration and factors influencing foot-related behaviour in patients with and without foot ulcers; and patient and podiatrist perspectives of consultations for diabetic foot ulcers. Methods: Two independent qualitative studies were undertaken: one with diabetic patients without a history of ulceration; and the other with diabetic patients with active ulceration and podiatrists treating these patients. Results: We found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations; and some podiatrists feel frustrated and unsupported in their attempts at empowering and building partnerships with patients. Conclusion: Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines. |
| doi_str_mv | 10.1258/jhsrp.2008.008011 |
| format | Article |
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Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses on two particular aspects of the programme: patient knowledge of diabetic foot ulceration and factors influencing foot-related behaviour in patients with and without foot ulcers; and patient and podiatrist perspectives of consultations for diabetic foot ulcers. Methods: Two independent qualitative studies were undertaken: one with diabetic patients without a history of ulceration; and the other with diabetic patients with active ulceration and podiatrists treating these patients. Results: We found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations; and some podiatrists feel frustrated and unsupported in their attempts at empowering and building partnerships with patients. Conclusion: Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines.</description><identifier>ISSN: 1355-8196</identifier><identifier>EISSN: 1758-1060</identifier><identifier>DOI: 10.1258/jhsrp.2008.008011</identifier><identifier>PMID: 18806197</identifier><identifier>CODEN: JHRPFD</identifier><language>eng</language><publisher>London, England: The Royal Society of Medicine Press Limited</publisher><subject>Aged ; Chronic sickness ; Cost of Illness ; Decision Making ; Diabetic Foot - prevention & control ; Diabetic Foot - therapy ; Diabetics ; England ; Feet ; Female ; Health behaviour ; Health information ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Original research ; Patient Education as Topic ; Patient Participation ; Practice Guidelines as Topic ; Self Care ; Ulcers</subject><ispartof>Journal of health services research & policy, 2008-10, Vol.13 (3_suppl), p.82-91</ispartof><rights>The Royal Society of Medicine Press Ltd 2008</rights><rights>2008 The Royal Society of Medicine Press Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-3911d860a71b355ecbad79aef91a200c1e606aa19ad492ec99407a2b2b7ac3993</citedby><cites>FETCH-LOGICAL-c423t-3911d860a71b355ecbad79aef91a200c1e606aa19ad492ec99407a2b2b7ac3993</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/26751216$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/26751216$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,30977,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18806197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Searle, Aidan</creatorcontrib><creatorcontrib>Gale, Lone</creatorcontrib><creatorcontrib>Campbell, Rona</creatorcontrib><creatorcontrib>Wetherell, Mark</creatorcontrib><creatorcontrib>Dawe, Karen</creatorcontrib><creatorcontrib>Drake, Nikki</creatorcontrib><creatorcontrib>Dayan, Colin</creatorcontrib><creatorcontrib>Tarlton, John</creatorcontrib><creatorcontrib>Miles, Jeremy</creatorcontrib><creatorcontrib>Vedhara, Kavita</creatorcontrib><title>Reducing the burden of chronic wounds: prevention and management of the diabetic foot in the context of clinical guidelines</title><title>Journal of health services research & policy</title><addtitle>J Health Serv Res Policy</addtitle><description>Objectives: Chronic wounds such as diabetic foot and venous leg ulcers are a major burden for health services. Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses on two particular aspects of the programme: patient knowledge of diabetic foot ulceration and factors influencing foot-related behaviour in patients with and without foot ulcers; and patient and podiatrist perspectives of consultations for diabetic foot ulcers. Methods: Two independent qualitative studies were undertaken: one with diabetic patients without a history of ulceration; and the other with diabetic patients with active ulceration and podiatrists treating these patients. Results: We found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations; and some podiatrists feel frustrated and unsupported in their attempts at empowering and building partnerships with patients. Conclusion: Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines.</description><subject>Aged</subject><subject>Chronic sickness</subject><subject>Cost of Illness</subject><subject>Decision Making</subject><subject>Diabetic Foot - prevention & control</subject><subject>Diabetic Foot - therapy</subject><subject>Diabetics</subject><subject>England</subject><subject>Feet</subject><subject>Female</subject><subject>Health behaviour</subject><subject>Health information</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original research</subject><subject>Patient Education as Topic</subject><subject>Patient Participation</subject><subject>Practice Guidelines as Topic</subject><subject>Self Care</subject><subject>Ulcers</subject><issn>1355-8196</issn><issn>1758-1060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkUuLFDEURgtRnHH0B7hQsnJW1eZWOi93MjgqDAii6yKV3OpOU5W0SZUP_POmuhrdjYuQB-f74OZU1XOgG2i4en3Y53TcNJSqTVkU4EF1CZKrGqigD8uZcV4r0OKiepLzgVJgAtTj6gKUogK0vKx-f0Y3Wx92ZNoj6ebkMJDYE7tPMXhLfsQ5uPyGHBN-xzD5GIgJjowmmB2O5WWBl6jzpsOpJPoYJ-LD6dHGMOHPE2MHX_rMQHazd1gumJ9Wj3ozZHx23q-qr7fvvtx8qO8-vf948_auttuGTTXTAE4JaiR0ZSC0nXFSG-w1mDK7BRRUGAPauK1u0Gq9pdI0XdNJY5nW7Kq6XnuPKX6bMU_t6LPFYTAB45xbKbZMCiYW8tW9pNBcMc3Yf0EuGymA8wLCCtoUc07Yt8fkR5N-tUDbRWJ7ktguEttVYsm8PJfP3YjuX-JsrQCbFchFQnuIcwrl_-5tfLEGDnmK6W9hIySHBgT7Az1kspA</recordid><startdate>20081001</startdate><enddate>20081001</enddate><creator>Searle, Aidan</creator><creator>Gale, Lone</creator><creator>Campbell, Rona</creator><creator>Wetherell, Mark</creator><creator>Dawe, Karen</creator><creator>Drake, Nikki</creator><creator>Dayan, Colin</creator><creator>Tarlton, John</creator><creator>Miles, Jeremy</creator><creator>Vedhara, Kavita</creator><general>The Royal Society of Medicine Press Limited</general><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>20081001</creationdate><title>Reducing the burden of chronic wounds: prevention and management of the diabetic foot in the context of clinical guidelines</title><author>Searle, Aidan ; 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Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses on two particular aspects of the programme: patient knowledge of diabetic foot ulceration and factors influencing foot-related behaviour in patients with and without foot ulcers; and patient and podiatrist perspectives of consultations for diabetic foot ulcers. Methods: Two independent qualitative studies were undertaken: one with diabetic patients without a history of ulceration; and the other with diabetic patients with active ulceration and podiatrists treating these patients. Results: We found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations; and some podiatrists feel frustrated and unsupported in their attempts at empowering and building partnerships with patients. Conclusion: Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines.</abstract><cop>London, England</cop><pub>The Royal Society of Medicine Press Limited</pub><pmid>18806197</pmid><doi>10.1258/jhsrp.2008.008011</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of health services research & policy, 2008-10, Vol.13 (3_suppl), p.82-91 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; MEDLINE |
| subjects | Aged Chronic sickness Cost of Illness Decision Making Diabetic Foot - prevention & control Diabetic Foot - therapy Diabetics England Feet Female Health behaviour Health information Health Knowledge, Attitudes, Practice Humans Male Middle Aged Original research Patient Education as Topic Patient Participation Practice Guidelines as Topic Self Care Ulcers |
| title | Reducing the burden of chronic wounds: prevention and management of the diabetic foot in the context of clinical guidelines |
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