Table 1

Key themes identified from the rapid scoping review of the psychosocial and behavioural issues, needs and challenges of people who have had DFUs

Key themesDetail from the literature
Lack of confidence in foot checking17 31
  • Some patients were uncertain about what a DFU was or looked like, what signs of DFUs to look out for and when the DFU was serious enough to seek help from a health professional. Such uncertainties may lead to delays in seeking help.

Feelings of lack of control in preventing DFUs17 31
  • Some patients felt they had little or no control in preventing further DFUs, as DFUs still occurred even when they were engaging in foot care behaviours.

  • Some patients believed that they were unable to prevent DFUs.

Difficult emotions following a DFU17 32–35
  • Some patients were fearful or worried about developing further DFUs, losing limbs through amputation and the impact a DFU reoccurrence might have on their lives.

  • Some patients felt down or had low self-esteem because of how the DFUs had negatively affected their everyday lives (eg, loss of independence, inability to work and provide for the family, lifestyle changes).

  • Some patients felt a sense of hopelessness, anger and frustration when DFUs developed despite their attempts to engage in foot care behaviours.

  • Some patients felt self-blame or guilt for not paying enough attention to their feet, not controlling their diabetes well, not following foot care advice or not engaging in foot care behaviours, especially in the event of reoccurrence.

  • Some patients experienced social isolation (eg, from restricted mobility, lack of employment) or felt a burden to others because they were dependent on them for daily activities (eg, cooking and driving).

  • Some patients found it difficult to share their experiences of a DFU with friends and family.

  • Some podiatrists acknowledged the emotional impact of DFUs on their patients, specifically the presence of anger, depression, anxiety and frustration.

Maintaining behaviours long term may be challenging17
  • Some patients were not confident that they could maintain foot care behaviours in the long term, with engagement likely to decrease over time.

  • Some patients were impatient to resume the physical activities they stopped when they had an active DFU, leading them to do too much activity and risk getting another DFU.

Physical limitations impeding foot checking35 40
  • Some patients and podiatrists reported physical limitations that prevented patients from engaging in foot care behaviours, including joint mobility problems, neuropathy and visual impairment.

Concerns over using digital interventions33
  • Some patients felt they did not have the necessary computer skills for internet or computer-based interventions.

  • DFU, diabetic foot ulcer.