{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:45:29Z","timestamp":1781887529278,"version":"3.54.5"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Foot complications in diabetes are common and destructive, resulting in substantial healthcare costs and high rates of morbidity. Coastal areas have a significantly higher burden of disease. People with diabetes experience disproportionately high rates of psychological health issues, including anxiety, depression and diabetes distress. These can affect self\u2010management and concordance with preventive measures and treatments of foot complications, negatively impacting on outcomes. Access to psychological health services is variable across the United Kingdom and there is a paucity of high\u2010quality evidence for the effectiveness of treatments for diabetes distress. This study aimed to explore experiences of psychosocial burden and perceptions and experiences of psychosocial support, among patients with diabetes and foot complications living in a coastal area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were eligible to participate if they had experienced diabetes\u2010related foot complications (amputation, ulceration and\/or Charcot neuroarthropathy) within the last 5\u00a0years and scored positive for diabetes distress on a validated screening tool (DDS2). Eligible patients completed cross\u2010sectional questionnaires describing symptoms of diabetes distress (DDS17), anxiety (GAD\u20107) and depression (PHQ\u20109) and to take part in a face\u2010to\u2010face, semi\u2010structured interview. Questionnaires were analysed using frequencies and interviews were analysed using reflexive thematic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 183 patients completed the DDS2 screening questionnaire. Of these, 56 (30.6%) screened positive for diabetes distress. Twenty\u2010seven patients completed DDS17, GAD\u20107 and PHQ\u20109 questionnaires. Eleven (40.7%) participants indicated high levels of diabetes distress and four (14.8%) indicated moderate distress. Seventeen participants (age range 52\u201381\u00a0years; 12 men) took part in an interview. Four key themes were identified: impact of living with foot problems; emotional consequences of foot problems; experiences and perceptions of psychological support; and strategies to cope with the emotional impact of foot problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diabetes distress was prevalent among patients with diabetes\u2010related foot complications. Foot problems impacted on participants' daily activities, social lives and ability to work. Despite expressing feelings of ongoing fear, worry and depression relating to their foot problems, only one participant had accessed formal psychological support. Many participants relied on talking to podiatrists at routine appointments and described developing various strategies to cope. The psychosocial burden of living with foot complications in diabetes must not be overlooked by health professionals. Findings from this study can inform the design of future services and interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jfa2.12038","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T03:55:01Z","timestamp":1719892501000},"source":"Crossref","is-referenced-by-count":8,"title":["Exploring the psychosocial burden of foot complications in diabetes: A cross\u2010sectional survey and qualitative interview study in a United Kingdom coastal community"],"prefix":"10.1002","volume":"17","author":[{"given":"Lara S.","family":"Chapman","sequence":"first","affiliation":[{"name":"Department of Podiatry Harrogate and District NHS Foundation Trust  Scarborough UK"},{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silva","family":"Cochrane","sequence":"additional","affiliation":[{"name":"Department of Podiatry Harrogate and District NHS Foundation Trust  Scarborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gill","family":"Sykes","sequence":"additional","affiliation":[{"name":"Department of Podiatry Harrogate and District NHS Foundation Trust  Scarborough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology York and Scarborough Teaching Hospitals NHS Foundation Trust  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Nixon","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Science University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Jayagopal","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology York and Scarborough Teaching Hospitals NHS Foundation Trust  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2021.01.017"},{"key":"e_1_2_12_3_1","unstructured":"Office for Health Improvement and Disparities.2022. \u201cNational Diabetes Foot Care Report.\u201d"},{"key":"e_1_2_12_4_1","unstructured":"Chief Medical Officer's Report 2021. \u201cHealth in Coastal Communites.\u201d"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0165\u20100327(12)70004\u20106"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.8040"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757\u20101146\u20107\u201022"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12428"},{"key":"e_1_2_12_9_1","unstructured":"DiabetesU. 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