Patients’ knowledge of diabetes foot complications and self-management practices in Ghana: A phenomenological study

Bossman, Irene; Dare, Shadrach; Oduro, Bright Anyimah; Baffour, Prince Kyei; Hinneh, Thomas; Nally, Jane E.

doi:10.1371/journal.pone.0256417

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…A lack of understanding of diabetes related foot disease and the perceived need for foot care was a common barrier identified by patients that prevented them from accessing foot care services. It has been well-established that patients with diabetes lack knowledge about foot complications and their prevention [33][34][35][36]. A lack of knowledge about one's condition and how it is managed has been shown to cause a low perceived need and reduction in care seeking across many chronic conditions [7].…”

Section: Discussionmentioning

confidence: 99%

Patient‐perceived and practitioner‐perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review

McPherson

Carroll

Stewart

2022

Journal of Foot and Ankle Research

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Background Foot-related complications are common in people with diabetes mellitus, however foot care services are underutilized by this population. This research aimed to systematically review the literature to identify patient and practitioner-perceived barriers to accessing foot care services for people with diabetes. Methods PRISMA guidelines were used to inform the data collection and extraction methods. CINAHL, MEDLINE, and Scopus databases were searched in March 2022 to identify original research articles that reported on barriers to accessing diabetes foot care services from the patient and/or practitioner perspective. Both quantitative and qualitative studies were included. The methodological quality of included studies was assessed using the Critical Appraisal Skills Program (CASP) tool for qualitative/mixed methods studies or the National Heart, Lung & Blood Institute (NHLBI) tool for quantitative studies. Following data extraction, content analysis was used to identify reported barriers. Themes and subthemes were presented separately for patient-perspectives and practitioner-perspectives. A narrative summary was used to synthesize the findings from the included studies. Results A total of 20 studies were included. The majority of CASP and NHLBI criteria were met by most studies, indicating good overall methodological quality. Three predominant themes emerged from the patient perspective that represented barriers to accessing foot care services: lack of understanding, socioeconomic factors, and lack of service availability. Four themes emerged from the practitioner perspective: poor interprofessional communication, lack of resources, lack of practitioner knowledge, and perceived patient factors. Conclusions This study has identified a number of barriers to accessing foot care services from both the patient and practitioner perspectives. Although patients focused predominantly on patient-level factors, while practitioners focused on barriers related to the health care system, there was some overlap between them. This emphasizes the importance of recognising both perspectives for the future integration of policy changes and access facilitators that may help to overcome these barriers.

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Section: Discussionmentioning

confidence: 99%

Patient‐perceived and practitioner‐perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review

McPherson

Carroll

Stewart

2022

Journal of Foot and Ankle Research

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“…These factors allow foot ulcers to progress and become chronic, nonhealing wounds. The inadequate management of underlying factors, such as uncontrolled diabetes and peripheral neuropathy, perpetuates this cycle, resulting in recurrent foot ulcers and an elevated risk of complications 24,25 …”

Section: Dfus In Lmics: Aetiology and Risk Factors Pathophysiology An...mentioning

confidence: 99%

“…A study in Ghana highlighted the significance of diabetic clinics as the primary source of education and understanding about DFUs to reduce diabetes‐related foot complications. 24 Categorizing patients based on risk factors at the primary health care level, particularly by nurses, is crucial for identifying those at risk for ulceration. This approach ensures accessibility to a broader population and is the initial entry point for individuals seeking foot health services.…”

Section: Future Strategies For Reducing Dfu‐related Amputations In Lmicsmentioning

confidence: 99%

Early intervention and care for Diabetic Foot Ulcers in Low and Middle Income Countries: Addressing challenges and exploring future strategies: A narrative review

Swaminathan,

Awuah,

Bharadwaj

et al. 2024

Health Science Reports

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Background and AimsDiabetic Foot Ulcers (DFUs) are a significant health concern, particularly in Low‐ and Middle‐Income Countries (LMICs). This review explores key strategies for managing DFUs in LMICs, including integrating podiatry, endocrinology, and wound care services, educating patients, promoting self‐care, and preventive measures to reduce amputation rates.MethodsA comprehensive literature review was conducted, focusing on studies conducted in Low and Middle Income Countries to facilitate a qualitative analysis. The review examined the aetiology and risk factors to developing DFUs, clinical presentation, multidisciplinary management and evidence based interventions, challenges to the provision of care and future directions, all pertaining to DFUs in low and middle income countries.ResultsThe aetiology and risk factors contributing to the development of DFUs are complex and multifaceted. Factors such as limited access to health care, inadequate diabetes management, and socioeconomic disparities significantly influence the incidence of DFUs. Clinical presentation varies, with patients often presenting at advanced stages of the disease due to delayed or missed diagnoses. Multidisciplinary management, incorporating podiatry, endocrinology, and wound care services, has exhibited substantial promise in enhancing patient outcomes. Evidence‐based interventions, including offloading techniques, wound debridement, and the use of advanced wound dressings, have proven effective in promoting ulcer healing.ConclusionThe burden of DFUs in LMICs requires comprehensive strategies. Integrating podiatry, endocrinology, and wound care services, along with patient education and self‐care practices, is essential for reducing amputations and improving patients' quality of life. Regular follow‐up and early detection are vital for effective DFU management, emphasizing the need for ongoing research and investment in LMIC health care infrastructure. Embracing these multidisciplinary, patient‐centered approaches can effectively address the challenge of DFUs in LMICs, leading to better patient outcomes and improved quality of life.

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“…There is a limited publication on DM self-management in the WHO African region although these studies have reported positive benefits of self-management (Kumah et al , 2021). The limited studies reported in the Ghanaian context places emphases disease management tasks such as foot care, self-care support and adherence to self-care recommendations (Mogre et al , 2019; Kumah et al , 2021; Bossman et al , 2021). However, to date, there does not appear to be any study focusing on people’s attitudes and behaviour around information for self-management for people living with DM.…”

Section: Research Problemmentioning

confidence: 99%

Understanding the information culture for self-management support of people living with diabetes in Ghana

Boamah

Druye

2022

DLP

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Purpose The purpose of this study is to explore the information culture of people living with Diabetes Mellitus (DM) and how that impacts their self-management practices in Ghana. The study focuses on the information experiences and information cultural patterns and creates awareness of the need for people to be aware of effective information management for sustainable self-management support. Design/methodology/approach An interpretive qualitative approach was used. A total of 12 interviewees involving 10 diabetes patients and 2 health professionals provided data for the study. Allowing the participants to freely talk about their attitude and behaviour, defining their experiences around information for their self-management was the best approach to achieve an in-depth understanding this study seeks. Findings The specific elements defining the information of people living with DM in Ghana can be identified. People living with the condition are willing to share information about their condition not only with those within their diabetic community but also with anyone interested. They prefer to use information from sources they find reliable and trust, and they have good information-related competencies that are consistent with diabetic patients in other countries’ contexts to help them identify, access, use and share relevant information. Only a few of the interviewees have difficulty in evaluating the accuracy and currency of some of the information. But they receive a lot of support from experienced people from their community. People also prefer to have information about the condition in their ethnic language. It is important for people living with the condition in Ghana to get involved in the diabetic groups, clubs and community, as members appear to receive the most benefit and support from the community to self-manage the condition alone. Research limitations/implications The study is limited by the number of participants and the distances between the researchers and the research context. Also, even though two groups of participants were interviewed (diabetic patients and health professionals), the analysis did not separate the responses of the different groups of study participants. This paper provides a useful insight and understanding of the culture of people living with diabetes in Ghana in terms of how they access, use and share the information they need to support their self-management. It will create awareness of the importance of being mindful of information culture patterns in people in other groups in Ghana and beyond. The research processes and procedures described in the paper can be replicated by other researchers in other contexts. Originality/value Although there have been a lot of studies about diabetes and people living with the condition in Ghana, to the best of the authors’ knowledge, this is the first study looking at how people define their need for information, how they identify the source of the information and how they access and use the information, including their general behavioural patterns that influence these information experiences.

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Patients’ knowledge of diabetes foot complications and self-management practices in Ghana: A phenomenological study

Cited by 15 publications

References 28 publications

Patient‐perceived and practitioner‐perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review

Patient‐perceived and practitioner‐perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review

Early intervention and care for Diabetic Foot Ulcers in Low and Middle Income Countries: Addressing challenges and exploring future strategies: A narrative review

Understanding the information culture for self-management support of people living with diabetes in Ghana

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