Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals: Qualitative Study

Abstract

BackgroundDiabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual’s quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals. ObjectiveThe study aimed to validate a structured foot examination form by assessing health care professionals’ experiences of working with it “foot side” when examining patients with diabetes. MethodsSemistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users’ data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled “Optimised care of persons with diabetes and foot complications,” with Västra Götaland Region as the responsible health care authority, where the results will be further developed. ResultsExperiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned. ConclusionsThe foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines. Trial RegistrationClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778