How do UK podiatrists promote self-care and support behaviour change in patients with diabetes mellitus?

  • Chloe Egan

    Student thesis: Master's ThesisMaster of Science by Research


    Diabetic foot disease places an immense financial burden on the National Health Service. Patient education promoting foot self-care is an integral part of diabetes management yet research shows that increased knowledge may not translate into behaviour change. Behaviour change techniques (BCTs) have the potential to promote foot self-care and reduce the incidence of diabetic foot disease. Therefore the primary aim of this study was to explore the practice and understanding of podiatrists towards patient-centred support versus prescriptive instruction in consultations regarding diabetic foot care. The secondary aim was to identify whether the number of years the podiatrist had been qualified influenced the participants responses.

    Ethical approval was obtained from Coventry University. The study was a cross-sectional design with an anonymous, self-administered, web-based questionnaire distributed via email to all members of the College of Podiatry with the Health and Care Professions Council (HCPC) registration working in the UK. A link was also posted on relevant Facebook groups UK Podiatry and footindiabetes. Descriptive statistics were used to analyse data regarding practice of the participants’. The questions investigating the participants’ knowledge were analysed using conceptual content analysis, and those that investigated barriers and facilitators were analysed using thematic analysis. The Pearson product-moment correlation coefficient was used to determine the strength of relationships between number of years qualified and frequency of use of behaviour change techniques in consultations, association between use of patient-centred language and use of prescriptive language, and association between respondents reporting that their consultations were patient-led and use of patient-centred language.

    The majority of respondents reported using BCTs in their consultations “often” or “very often” and that they “strongly agree or “agree” that their consultations were patient-led. However, the majority of respondents were categorised as having a partial or poor understanding of the terms “behaviour change techniques” and “patient-led consultation”. Three themes emerged from the thematic analysis regarding barriers and facilitators to support behaviour change, including “Skills and confidence”, “Patients do not want to take control” and “The system”. No correlation was found between any of the variables investigated.

    This study explored the practice of podiatrists and their use of BCTs using an on-line survey. Respondents believed that they were utilising BCTs and a patient-led approach yet their answers suggested otherwise. Conflict in their answers suggested a lack of understanding of BCTs, which may have led to respondents over reporting their use of BCTs and a patient-led consultation style. A need for institutional changes and organisational support was highlighted by the respondents. This included extra time to undertake training to develop the adequate skills, knowledge and confidence and extra time in appointments to implement a patient-led consultation style in their practice.

    Date of AwardAug 2021
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorDeborah Lycett (Supervisor) & Bernice Tighe (Supervisor)

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