{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:16:07Z","timestamp":1788542167982,"version":"build-2803163510"},"reference-count":50,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Tissue Viability"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.jtv.2025.100960","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:43:14Z","timestamp":1758948194000},"page":"100960","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cognitive gaps and educational needs in foot self-care among patients with diabetic foot from a health literacy perspective: A qualitative study"],"prefix":"10.1016","volume":"34","author":[{"given":"Xiaodan","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianghao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuantian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haidan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhou","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtv.2025.100960_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"issue":"9","key":"10.1016\/j.jtv.2025.100960_bib2","first-page":"757","article-title":"Chinese guidelines for the prevention and control of type 2 diabetes mellitus (2020 edition) (below)","volume":"41","year":"2021","journal-title":"Chin J Pract Intern Med"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib3","first-page":"363","article-title":"Definition and standards of diabetic foot","volume":"12","author":"Huifeng","year":"2020","journal-title":"Chin J Diabet"},{"issue":"4","key":"10.1016\/j.jtv.2025.100960_bib4","first-page":"635","article-title":"Research progress on etiology and anti-infection treatment of diabetic foot infection Chinese","volume":"34","author":"Xiaohan","year":"2024","journal-title":"J Nosocomiol"},{"key":"10.1016\/j.jtv.2025.100960_bib5","unstructured":"Federation ID. Diabetes global report 2000 \u2014 2050. Available from: https:\/\/diabetesatlas.org\/data-by-location\/global\/. ."},{"issue":"4","key":"10.1016\/j.jtv.2025.100960_bib6","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1007\/s11010-022-04372-w","article-title":"Clinically relevant experimental rodent models of diabetic foot ulcer","volume":"477","author":"Rai","year":"2022","journal-title":"Mol Cell Biochem"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib7","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3657","article-title":"Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update)","volume":"40","author":"Schaper","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"10.1016\/j.jtv.2025.100960_bib8","series-title":"Retrospective analysis of case data in 284 patients with diabetic foot","author":"Zhi","year":"2012"},{"issue":"16","key":"10.1016\/j.jtv.2025.100960_bib9","first-page":"176","article-title":"Investigation on foot care knowledge and foot self-care behaviors in high-risk diabetic foot patients","volume":"32","author":"Manqing","year":"2019","journal-title":"Med Equip"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib10","first-page":"256","article-title":"Association between foot care knowledge and practices among African Americans with type 2 diabetes: an exploratory pilot study","volume":"111","author":"Bonner","year":"2019","journal-title":"J Natl Med Assoc"},{"issue":"8","key":"10.1016\/j.jtv.2025.100960_bib11","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1002\/dmrr.2523","article-title":"Burden of diabetic foot disorders, guidelines for management and disparities in implementation in Europe: a systematic literature review","volume":"30","author":"Van Acker","year":"2014","journal-title":"Diabetes Metab Res Rev"},{"issue":"4","key":"10.1016\/j.jtv.2025.100960_bib12","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18041891","article-title":"Prevalence and medical resource of patients with diabetic foot ulcer: a nationwide population-based retrospective cohort study for 2001-2015 in Taiwan","volume":"18","author":"Tai","year":"2021","journal-title":"Int J Environ Res Publ Health"},{"issue":"12","key":"10.1016\/j.jtv.2025.100960_bib13","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1016\/j.socscimed.2008.09.050","article-title":"The evolving concept of health literacy","volume":"67","author":"Nutbeam","year":"2008","journal-title":"Soc Sci Med"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib14","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s11606-019-04832-y","article-title":"The role of health literacy in diabetes knowledge, self-care, and glycemic control: a meta-analysis","volume":"34","author":"Marciano","year":"2019","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.jtv.2025.100960_bib15","series-title":"Study on foot self-care behaviors among elderly type 2 diabetes patients at hight-risk of diabetic foot and influencing factors thereof","author":"Na","year":"2023"},{"issue":"10","key":"10.1016\/j.jtv.2025.100960_bib16","first-page":"5","article-title":"The status quo and influencing factors of foot skin problems among patients with diabetes","volume":"37","author":"Xinyi","year":"2020","journal-title":"Milit Nurs"},{"issue":"27","key":"10.1016\/j.jtv.2025.100960_bib17","first-page":"3228","article-title":"Interpretation of the best practice guideline by registered nurses' association of Ontario--Evaluation and management of diabetic foot ulcer patients","volume":"24","author":"Xuejing","year":"2018","journal-title":"Chin J Mod Nurs"},{"issue":"10","key":"10.1016\/j.jtv.2025.100960_bib18","first-page":"188","article-title":"Progress in health literacy in patients with type 2 diabetes","volume":"19","author":"Zhu","year":"2022","journal-title":"Health Med Res Pract"},{"issue":"7","key":"10.1016\/j.jtv.2025.100960_bib19","first-page":"530","article-title":"Progress of research on health literacy of Chinese residents. Chinese journal of prevention and control of chronic","volume":"29","author":"Yinghong","year":"2021","journal-title":"Diseases"},{"issue":"2","key":"10.1016\/j.jtv.2025.100960_bib20","first-page":"282","article-title":"Yang lili research progress on assessment instruments of condition-specific health literacy for people with diabetes mellitus","volume":"24","author":"Liu Suciang","year":"2024","journal-title":"Adv Nurs Pract"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib21","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib22","doi-asserted-by":"crossref","first-page":"511","DOI":"10.3724\/SP.J.1042.2022.00511","article-title":"Concepts and evaluation of saturation in qualitative research","volume":"30","author":"Liping","year":"2022","journal-title":"Adv Psychol Sci"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib23","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)","volume":"40","author":"Bus","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"10.1016\/j.jtv.2025.100960_bib24","doi-asserted-by":"crossref","first-page":"3557","DOI":"10.2147\/PPA.S435632","article-title":"Patients' expectations of evidence-based service at the pharmacy regarding information on self-care of the feet for persons with diabetes at risk of developing foot ulcers - a cross-sectional observational study in Sweden","volume":"17","author":"Hellstrand Tang","year":"2023","journal-title":"Patient Prefer Adherence"},{"issue":"11","key":"10.1016\/j.jtv.2025.100960_bib25","first-page":"90","article-title":"Using an example to illustrate Colaizzi's phenomenological data analysis method","volume":"34","author":"Ming","year":"2019","journal-title":"J Nurs Sci"},{"key":"10.1016\/j.jtv.2025.100960_bib26","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2023.1111565","article-title":"Current status and influential factors associated with adherence to self-monitoring of blood glucose with type 2 diabetes mellitus patients in grassroots communities: a cross-sectional survey based on information-motivation-behavior skills model in China","volume":"14","author":"Lin","year":"2023","journal-title":"Front Endocrinol"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib27","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1186\/s12877-025-06000-w","article-title":"Application of the information-motivation-behavioral skills model to improve medication adherence among older adults with type 2 diabetes: findings from a quasi-experimental study in Kermanshah, Iran","volume":"25","author":"Mirzaei-Alavijeh","year":"2025","journal-title":"BMC Geriatr"},{"key":"10.1016\/j.jtv.2025.100960_bib28","doi-asserted-by":"crossref","DOI":"10.1016\/j.ypmed.2020.106296","article-title":"A model exploring the relationship between nutrition knowledge, behavior, diabetes self-management and outcomes from the dining with diabetes program","volume":"141","author":"Misra","year":"2020","journal-title":"Prev Med"},{"key":"10.1016\/j.jtv.2025.100960_bib29","doi-asserted-by":"crossref","DOI":"10.1016\/j.pec.2023.107986","article-title":"Underlying mechanisms of diabetes knowledge influencing diabetes self-management behaviors among patients with type II diabetes in rural China: based on health belief model","volume":"117","author":"Wang","year":"2023","journal-title":"Patient Educ Counsel"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib30","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40959-022-00151-0","article-title":"Patient similarity and other artificial intelligence machine learning algorithms in clinical decision aid for shared decision-making in the prevention of cardiovascular toxicity (PACT): a feasibility trial design","volume":"9","author":"Brown","year":"2023","journal-title":"Cardio-Oncology"},{"key":"10.1016\/j.jtv.2025.100960_bib31","doi-asserted-by":"crossref","DOI":"10.1016\/j.pec.2023.107752","article-title":"The use of narrative in science and health communication: a scoping review","volume":"112","author":"Dudley","year":"2023","journal-title":"Patient Educ Counsel"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib32","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s41111-021-00200-6","article-title":"Rethinking the methodological foundation of historical political science","volume":"7","author":"Shi","year":"2022","journal-title":"Chin Polit Sci Rev"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib33","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1111\/jocn.17380","article-title":"Diabetes self-care activities and its correlates in patients with diabetic neuropathy","volume":"34","author":"Kang","year":"2025","journal-title":"J Clin Nurs"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib34","first-page":"998","article-title":"Relationship between social isolation and health behaviors and uicer severity in diabetic foot patients","volume":"53","author":"Lu","year":"2022","journal-title":"J Sichuan Univ"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib35","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1186\/s12889-024-17917-z","article-title":"Factors associated with quality of life among elderly patients with type 2 diabetes mellitus: the role of family caregivers","volume":"24","author":"Zan","year":"2024","journal-title":"BMC Public Health"},{"issue":"10","key":"10.1016\/j.jtv.2025.100960_bib36","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/JXX.0000000000000469","article-title":"Implementation and evaluation of a self-care toolkit for caregivers of families with dementia","volume":"33","author":"Smith","year":"2020","journal-title":"J Am Assoc Nurse Pract"},{"issue":"6","key":"10.1016\/j.jtv.2025.100960_bib37","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1177\/02692163211009440","article-title":"Impact of physician-based palliative care delivery models on health care utilization outcomes: a population-based retrospective cohort study","volume":"35","author":"Brown","year":"2021","journal-title":"Palliat Med"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib38","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s13643-025-02862-8","article-title":"How can interprofessional collaboration be fostered and sustained in team-based care integration for older people in community settings? A realist evidence synthesis","volume":"14","author":"O'Donnell","year":"2025","journal-title":"Syst Rev"},{"key":"10.1016\/j.jtv.2025.100960_bib39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijmedinf.2017.04.017","article-title":"Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: non-government versus government supported funding models","volume":"104","author":"Akiyama","year":"2017","journal-title":"Int J Med Inform"},{"issue":"4","key":"10.1016\/j.jtv.2025.100960_bib40","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1177\/193229681300700433","article-title":"Diabetes device reimbursement in the EU-5","volume":"7","author":"Sch\u00e4fer","year":"2013","journal-title":"J Diabetes Sci Technol"},{"issue":"9","key":"10.1016\/j.jtv.2025.100960_bib41","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2120180119","article-title":"Information overload and resilience in facing foundational issues","volume":"119","author":"Bretscher","year":"2022","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib42","doi-asserted-by":"crossref","DOI":"10.3390\/bs13030267","article-title":"Research on the process and influencing factors of online diabetes information users' avoidance behavior: a qualitative study","volume":"13","author":"Guo","year":"2023","journal-title":"Behav Sci"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib43","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12875-023-02129-y","article-title":"Structured communication methods for mental health consultations in primary care: a scoping review","volume":"24","author":"Mosler","year":"2023","journal-title":"BMC Prim Care"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib44","doi-asserted-by":"crossref","first-page":"42","DOI":"10.3349\/ymj.2023.0183","article-title":"Questionnaire-based survey of diabetes self-care activities and barriers among young Korean adults with early-onset diabetes","volume":"65","author":"Park","year":"2024","journal-title":"Yonsei Med J"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib45","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41581-021-00534-z","article-title":"The perils of misinformation: when health literacy goes awry","volume":"18","author":"Schulz","year":"2022","journal-title":"Nat Rev Nephrol"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib46","doi-asserted-by":"crossref","DOI":"10.2196\/17187","article-title":"Prevalence of health misinformation on social media: systematic review","volume":"23","author":"Suarez-Lledo","year":"2021","journal-title":"J Med Internet Res"},{"issue":"3","key":"10.1016\/j.jtv.2025.100960_bib47","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1038\/s41591-022-01713-6","article-title":"Misinformation: susceptibility, spread, and interventions to immunize the public","volume":"28","author":"van der Linden","year":"2022","journal-title":"Nat Med"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib48","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13047-020-00413-z","article-title":"Predictors of adherence to wearing therapeutic footwear among people with diabetes","volume":"13","author":"Jarl","year":"2020","journal-title":"J Foot Ankle Res"},{"issue":"1","key":"10.1016\/j.jtv.2025.100960_bib49","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/hex.13377","article-title":"Tailored patient therapeutic educational interventions: a patient-centred communication model","volume":"25","author":"Ricci","year":"2022","journal-title":"Health Expect"},{"key":"10.1016\/j.jtv.2025.100960_bib50","doi-asserted-by":"crossref","DOI":"10.1016\/j.nedt.2023.106002","article-title":"Impact of an immersive virtual reality simulator education program on nursing students' intravenous injection administration: a mixed methods study","volume":"132","author":"Chang","year":"2024","journal-title":"Nurse Educ Today"}],"updated-by":[{"DOI":"10.1016\/j.jtv.2025.100972","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000}},{"DOI":"10.1016\/j.jtv.2025.100972","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000}}],"container-title":["Journal of Tissue Viability"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0965206X25001081?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0965206X25001081?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:16:30Z","timestamp":1778098590000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0965206X25001081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":50,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S0965206X25001081"],"URL":"https:\/\/doi.org\/10.1016\/j.jtv.2025.100960","relation":{},"ISSN":["0965-206X"],"issn-type":[{"value":"0965-206X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Cognitive gaps and educational needs in foot self-care among patients with diabetic foot from a health literacy perspective: A qualitative study","name":"articletitle","label":"Article Title"},{"value":"Journal of Tissue Viability","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jtv.2025.100960","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd on behalf of Society of Tissue Viability.","name":"copyright","label":"Copyright"}],"article-number":"100960"}}