Barriers and enablers to delivering preventative and early intervention footcare to people with diabetes: a scoping review of healthcare professionals’ perceptions
Leanne Mullan A D , Andrea Driscoll A B , Karen Wynter A C and Bodil Rasmussen A C
+ Author Affiliations
- Author Affiliations
A School of Nursing and Midwifery, Deakin University, 1 Gheringhap Street, Geelong, Vic. 3220, Australia.
B Austin Health, Department of Cardiology, Studley Road, Heidelberg, Vic. 3084, Australia.
C Centre for Quality and Patient Safety Research – Western Health Partnership, Sunshine Hospital, 176 Furlong Road, St Albans, Vic. 3021, Australia.
D Corresponding author. Email: mulea@deakin.edu.au
Australian Journal of Primary Health 25(6) 517-525 https://doi.org/10.1071/PY19115
Submitted: 27 May 2019 Accepted: 4 August 2019 Published: 13 November 2019
Abstract
The aim of this study is to examine barriers and enablers to delivering preventative and early intervention footcare to people with diabetes, from the perspective of healthcare professionals within primary care. MEDLINE, CINAHL and Scopus databases, as well as Google Scholar, were searched in September 2018. Inclusion criteria included: English language, qualitative and quantitative studies, since 1998, reporting on barriers or enablers, as reported by primary care health professionals, to delivering preventative or early intervention footcare to people with diabetes. In total, 339 studies were screened. Eight studies met criteria. Perceived barriers to providing footcare included: geographical, administrative and communication factors; referral and care guideline availability and implementation challenges; limited availability of specialists and high-risk foot services; and limited resources including time and funding. Enablers to footcare were: implementation of footcare programs; education; clear definition of staff roles; development of foot assessment reminder systems; and reminders for people with diabetes to remove their shoes at appointments. Barriers and enablers to footcare are multifaceted. Healthcare professionals are affected by health system and individual factors. By implementing strategies to address barriers to footcare delivery, it is possible to improve outcomes for people with diabetes, thus reducing the effect of diabetes-related foot disease.
Additional keywords: diabetic foot disease, foot, prevention, primary care.
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