Healing Through Empowerment and Active Listening: Experience‐Based Co‐Design of a Nurse‐Led Personalised Self‐Care Support Intervention for Primary Care Patients With Diabetic Foot Ulcers.
Background: The rising prevalence of diabetic foot ulcers (DFUs) highlights the need for effective self‐care interventions. Despite strong evidence supporting their effectiveness, patient engagement, uptake, and integration into routine care remain limited. Co‐design approaches can enhance the relev...
| Publicado en: | Health Expectations Vol. 28; no. 4; pp. 1 - 19 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187616952&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187616952 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13696513 EVY jtl: Health Expectations issn: 13696513 maglogo: Y pubinfo: dt: Aug2025 vid: 28 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 187616952 187616952 187616952 10.1111/hex.70386 187616952 ppf: 1 ppct: 18 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Healing Through Empowerment and Active Listening: Experience‐Based Co‐Design of a Nurse‐Led Personalised Self‐Care Support Intervention for Primary Care Patients With Diabetic Foot Ulcers. aug: au: Zhu, Xiaoli Lee, Eng Sing Chan, Frederick H. F. Yin, Ruoyu Koh, Rachel W. S. Lim, Phoebe X. H. Judith, Carpenter Lim, Voon Hooi Low, Richard S. Y. Chen, Yee Chui Chen, Yan Wang, Xiuhong Ng, Pei Pei Tan, Catherine T. Y. Tan, Sonia Pereira, Katrina Griva, Konstadina affil: NHG Polyclinics, NHG Health,, Singapore sug: subj: Diabetic Foot Nursing Diabetic Foot Therapy Wound Healing Empowerment Listening Self Care Self Concept Psychological Theory Motivational Interviewing Stakeholder Participation Human Singapore Funding Source Male Female Multimethod Studies Primary Health Care Audiorecording Thematic Analysis Conceptual Framework Nursing Practice Health Priorities Structural Equation Modeling Confidence Emotions Motivation Help Seeking Behavior Male Female ab: Background: The rising prevalence of diabetic foot ulcers (DFUs) highlights the need for effective self‐care interventions. Despite strong evidence supporting their effectiveness, patient engagement, uptake, and integration into routine care remain limited. Co‐design approaches can enhance the relevance and adoption of interventions but are underutilized in DFU management. Objectives: This study outlines the development of Healing through Empowerment and Active Listening (HEALing), a self‐care intervention for patients with DFU, grounded in Self‐Determination Theory and Motivational Interviewing, and developed using an experience‐based co‐design approach. Design, Setting and Participants: The 27‐month co‐design process consisted of three phases involving patients, caregivers, healthcare professionals(HCPs), and researchers from across primary care in Singapore. Phase 1 (16 months) included qualitative interviews with patients (N = 27), caregivers (N = 5), and HCPs (N = 8), analyzed via reflexive thematic analysis, alongside a quantitative survey (N = 186), analyzed using structural equation modelling to identify intervention determinants. Phase 2 (9 months) involved co‐design workshops with patients (N = 10) and wound care nurses (N = 6) to define the intervention's content and delivery approach. In Phase 3 (2 months), iterative meetings refined the intervention's procedures, tools, and materials. Qualitative data from Phases 2 and 3 were thematically analyzed. Results: Key barriers to DFU self‐care included limited control over ulceration and treatment, low confidence, negative emotions, and misperceptions about the condition. Personalised care and clinician‐facilitated motivation emerged as key enablers. HEALing targets five core self‐care components: (1) wound care, (2) foot care and footwear, (3) diabetes care, (4) treatment seeking, and (5) managing worries and concerns. The personalised components are delivered using a card‐sorting tool during clinic‐integrated sessions by trained wound care nurses. The HEALing delivery pathway comprises three 30‐min sessions at 2‐week intervals. During workshops, participants perceived HEALing as supporting patient‐ and clinician‐endorsed person‐centred care and collaborative planning, while also identifying potential implementation challenges, including training needs and structural barriers. Conclusions: HEALing positions patients as experts by experience, addressing the psychological and behavioural complexities of DFU care. This nurse‐led and stakeholder‐endorsed intervention is currently undergoing feasibility evaluation. Patient and Public Involvement: Individuals with DFUs, their caregivers, and those with post‐healing in remission, and wound care nurses as service users contributed to co‐design HEALing by identifying intervention targets and shaping the intervention's content and delivery. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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