{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:57:13Z","timestamp":1791266233371,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004901","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de Minas Gerais","doi-asserted-by":"publisher","award":["APQ\u201004289\u201022"],"award-info":[{"award-number":["APQ\u201004289\u201022"]}],"id":[{"id":"10.13039\/501100004901","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["420227\/2023\u20107"],"award-info":[{"award-number":["420227\/2023\u20107"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Diabetes\u2010related distress (DRD) is exacerbated in people at risk of Diabetes\u2010related Foot Disease (DFD); however, knowledge on this topic is still limited, especially in Primary Health Care (PHC), which focuses on prevention and monitoring. This study evaluated DRD and its associated factors in PHC individuals at risk of developing DFD, aiming to support management strategies to reduce complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional study with 1563 individuals with diabetes mellitus (DM) registered in PHC services in Brazil. Participants were stratified according to their risk of DFD, based on the criteria from the International Working Group on the Diabetic Foot. The DRD was measured using the Problem Areas in Diabetes (B\u2010PAID) scale, considering a score \u2265\u00a040 as indicative of high distress. Sociodemographic, clinical, and behavioral variables were collected and analyzed using Gamma regression on the software\n                      <jats:italic>Statistical Package for the Social Sciences<\/jats:italic>\n                      (SPSS 26.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1563 people with DM, 39.8% were at risk for DFD. In the multiple regression model, there is notable increase in DRD associated with greater difficulty in caring for the feet (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a01.129; 1.014\u20131.257), loss of protective sensation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a01.311; 1.110\u20131.549), and poor glycemic control (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.850; 0.761\u20130.951).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sociodemographic and clinical factors, particularly loss of protective sensation in the feet, difficulty in foot care, and inadequate control of glycated hemoglobin, are associated with greater DRD in people at risk for DFD. Primary health care stands out as a strategic space for integrating psychosocial support and clinical management, ensuring that preventive measures are implemented and resulting complications are avoided or detected early.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jfa2.70194","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T03:01:48Z","timestamp":1785380508000},"source":"Crossref","is-referenced-by-count":0,"title":["Diabetes Distress in People at Risk for Diabetes\u2010Related Foot Disease in Primary Health Care"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7858-6027","authenticated-orcid":false,"given":"Thallita Cl\u00e1udia","family":"Moraes Barbosa","sequence":"first","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9257-5992","authenticated-orcid":false,"given":"Let\u00edcia Eug\u00eanio","family":"Mota","sequence":"additional","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3500-0839","authenticated-orcid":false,"given":"Maria Gabriela","family":"Campos Nunes","sequence":"additional","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2080-7488","authenticated-orcid":false,"given":"Laura Andrade","family":"Pinto","sequence":"additional","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7400-021X","authenticated-orcid":false,"given":"Let\u00edcia Alves","family":"Rocha","sequence":"additional","affiliation":[{"name":"Nursing Department Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-4917","authenticated-orcid":false,"given":"Patricia","family":"Peres de Oliveira","sequence":"additional","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-1175","authenticated-orcid":false,"given":"Vinicius","family":"Silva Belo","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4644-274X","authenticated-orcid":false,"given":"Daniel","family":"Nogueira Cortez","sequence":"additional","affiliation":[{"name":"Graduate Program in Nursing Federal University of S\u00e3o Jo\u00e3o del\u2010Rei\/Central\u2010West Campus  Divinopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23\u2010S006"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/08445621231206982"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201028320\u2010y"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14897"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.888924"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/1413\u201081232025301"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_12_10_1","volume-title":"Sample Size Determination in Health Studies: A Practical Manual","author":"Lwanga S.","year":"1991"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110594"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2006.09.022"},{"key":"e_1_2_12_13_1","volume-title":"Classifications and Lists","author":"Brazilian Institute of Geography and Statistics","year":"2026"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13098\u2010025\u201001954\u20108"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.25270\/wnds\/24184"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40200\u2010022\u201001103\u20102"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201055901\u20100"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/3946553"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201008246\u20101"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/JXX.0000000000000998"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000913"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1590\/0034\u20107167\u20102022\u20100668"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3651"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2023.110810"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.5114\/ctd\/160061"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.944239"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/11795514231189048"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1195483"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392\u2010023\u201001376\u2010w"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102023\u2010003523"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010019\u20108133\u2010y"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010024\u201011219\u20101"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102023\u2010077693"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112014"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u2010S005"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.98974"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2025.100313"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012835"}],"container-title":["Journal of Foot and Ankle Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jfa2.70194","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jfa2.70194","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jfa2.70194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:49:20Z","timestamp":1791265760000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jfa2.70194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/jfa2.70194"],"URL":"https:\/\/doi.org\/10.1002\/jfa2.70194","archive":["Portico"],"relation":{},"ISSN":["1757-1146","1757-1146"],"issn-type":[{"value":"1757-1146","type":"print"},{"value":"1757-1146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"article-number":"e70194"}}