Key Improvements in Healthcare for Persons With Diabetes at Risk of Developing Foot Ulcers: A Concept Mapping Study.

BACKGROUND: Diabetic foot ulcers (DFUs) are a serious complication of diabetes, with a lifetime risk of up to 34%. Despite preventive guidelines, gaps remain in the care chain. This study aimed to identify and prioritise improvements in DFU prevention, care, and self-care in the Region Västra Götaland, Sweden. METHODS: A participatory action research design was used as part of a larger observational co-design study. Patients with diabetes, healthcare professionals, and researchers participated. Data were collected through Concept Mapping to generate and cluster ideas, followed by a workshop to prioritise improvements. The improvements were assessed regarding feasibility and importance ranging from 0 to 7, with exceptions that some participants scored ideas > 7. RESULTS: Thirty-one participants contributed and based on 83 ideas five clusters were generated: (1) Examination of the feet by healthcare professionals, (2) Exchange of knowledge/Exchange of experiences, (3) Access to podiatry, (4) Economy/Equal care, and (5) Other/Support for self-care. In a workshop with 22 participants, the three prioritised ideas were: (1) Having access to podiatry if problems occur, (2) Getting help when problems arise, and (3) Information from the healthcare about the importance of good foot healthcare. These ideas got 80% or more of all votes within each of the five clusters and were scored > 5 for feasibility and of > 7 for importance. Other prioritised ideas involved enhancing individual self-care capabilities and maintaining personalised interactions despite digitalisation. CONCLUSIONS: Timely access to podiatry, increased foot health awareness among healthcare professionals, and rapid intervention when problems arise were identified as key priorities for improving DFU care and patient outcomes.