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The assessment and management of diabetes related lower limb problems in India - an action research approach to integrating best practice

Harrison-Blount, MJ, Cullen, MB, Nester, CJ and Williams, AE 2014, 'The assessment and management of diabetes related lower limb problems in India - an action research approach to integrating best practice' , Journal of Foot and Ankle Research, 7 (30) .

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Abstract

Background In this article the authors explore the current issues and barriers related to achieving successful outcomes to diabetic foot complications in India. This was achieved by engaging clinicians in taking ownership of the problems and facilitating them in the identification of solutions to action change in clinical practice. Methods This was accomplished through facilitating participants in this study via a process of problem identification and planning, the first phases of an action research cycle approach. The methods of data collection were focus groups, observations and individual conversations. The data were analysed using a thematic framework. Findings: Based on the practitioner's experiences and opinions, key themes were identified. These themes had the potential to inform the changes needed in clinical practice, to overcome barriers and embed ownership of the solutions. Five themes were identified highlighting: concerns over a fragmented service; local recognition of need; lack of standardised care pathways; lack of structured assessment and an absence of annual foot screening. Combined, the issues identified were thought to be important in preventing timely assessment and management of foot problems. Conclusion It was unanimously agreed that a formalised process of foot assessment should be developed and implemented as part of the subsequent phases of the action research process, which the authors intended to take forward and report in a further paper. The aim of which is to guide triage, education, care pathways, audit and evaluation of outcomes. Facilitation of the clinicians in developing a program and screening tool to implement and teach these skills to others could be an important step in reducing the number of high-risk cases that are often resulting in the amputation of limbs.

Item Type: Article
Uncontrolled Keywords: Diabetes, Focus groups, Participatory action research, Care pathway, Foot screening
Themes: Health and Wellbeing
Schools: Schools > School of Health Sciences > Centre for Health Sciences Research
Schools > School of Health Sciences
Journal or Publication Title: Journal of Foot and Ankle Research
Publisher: BioMed Central
Refereed: Yes
ISSN: 1757-1146
Funders: Non funded research
Depositing User: Michael J Harrison-Blount
Date Deposited: 27 May 2014 11:08
Last Modified: 30 Nov 2015 23:42
URI: http://usir.salford.ac.uk/id/eprint/31856

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