{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:48:22Z","timestamp":1791182902317,"version":"4.1.0"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1463423625100698_as1\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To explore nurses\u2019 perceptions regarding their knowledge, degree of autonomy, and the difficulties encountered in managing diabetic foot in Primary Care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423625100698_as2\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diabetes mellitus is a chronic condition with a high prevalence in Spain, predominantly type 2. One of its most serious complications is diabetic foot disease, affecting between 19% and 34% of patients and associated with considerable morbidity and amputation risk. Primary Care, particularly nursing professionals, plays a pivotal role in the prevention, assessment, and management of diabetic foot. However, institutional, methodological, and personal barriers continue to affect care quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423625100698_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A descriptive, cross-sectional observational study was conducted using quantitative and qualitative methods. A validated ad hoc questionnaire was administered to 176 nurses from the Murcian Health Service participating in a blended learning course on diabetic foot. Variables assessed included professional autonomy, knowledge, dressings use, clinical documentation, training, and perceived challenges. Qualitative analysis was based on open-ended responses using content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423625100698_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>A total of 88.1% of nurses reported autonomy in performing foot examinations; however, only 45.5% managed wound care independently. Just 19.9% considered themselves sufficiently trained, while 42.6% felt confident in selecting dressings appropriate to the healing phase. Although 56.8% regularly completed specific clinical documentation forms, many still expressed uncertainty about dressing use. Qualitative analysis identified five key barriers: lack of knowledge, patient complexity, institutional constraints, issues of authority and communication, and professional insecurity. These findings provide a current picture of persistent barriers in diabetic foot care and reinforce the need for targeted training and institutional support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1463423625100698","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:32:19Z","timestamp":1766986339000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Barriers and competencies in nursing care for diabetic foot management: a mixed-methods observational study"],"prefix":"10.1017","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8420-3450","authenticated-orcid":false,"given":"M\u00f3nica","family":"Rodr\u00edguez Valiente","sequence":"first","affiliation":[{"name":"Virgen de la Arrixaca University Clinical Hospital \u2013 IMIB, UDICA \u2013 Teaching, Research and Healthcare Quality Unit"},{"id":[{"id":"https:\/\/ror.org\/05b1rsv17","id-type":"ROR","asserted-by":"publisher"}],"name":"UCAM Universidad Cat\u00f3lica de Murcia"},{"name":"UCAM"},{"name":"Biomedical Research Institute of Murcia Pascual Parrilla\u2013IMIB"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5098-6250","authenticated-orcid":false,"given":"Roberto Carlos","family":"Mart\u00ednez Alcaraz","sequence":"additional","affiliation":[{"name":"Murcian Health Service"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7430-7775","authenticated-orcid":false,"given":"Javier","family":"S\u00e1nchez-G\u00e1lvez","sequence":"additional","affiliation":[{"name":"Virgen de la Arrixaca University Clinical Hospital \u2013 IMIB, UDICA \u2013 Teaching, Research and Healthcare Quality Unit"},{"id":[{"id":"https:\/\/ror.org\/05b1rsv17","id-type":"ROR","asserted-by":"publisher"}],"name":"UCAM Universidad Cat\u00f3lica de Murcia"},{"name":"UCAM"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8402-6296","authenticated-orcid":false,"given":"Francisco","family":"Mateo Ram\u00edrez","sequence":"additional","affiliation":[{"name":"International University of La Rioja"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6923-0962","authenticated-orcid":false,"given":"Juan Jes\u00fas","family":"Ba\u00f1o Egea","sequence":"additional","affiliation":[{"name":"Murcian Health Service"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0594-5444","authenticated-orcid":false,"given":"Mar\u00eda Cristina","family":"Sole-August\u00ed","sequence":"additional","affiliation":[{"name":"Murcian Health Service"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9529-7901","authenticated-orcid":false,"given":"Arturo","family":"Pereda M\u00e1s","sequence":"additional","affiliation":[{"name":"Virgen de la Arrixaca University Clinical Hospital \u2013 IMIB, UDICA \u2013 Teaching, Research and Healthcare Quality Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-0340","authenticated-orcid":false,"given":"Mar\u00eda Dolores","family":"Beteta Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Virgen de la Arrixaca University Clinical Hospital \u2013 IMIB, UDICA \u2013 Teaching, Research and Healthcare Quality Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"S1463423625100698_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.endien.2020.08.016"},{"key":"S1463423625100698_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"S1463423625100698_ref5","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8549567"},{"key":"S1463423625100698_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2020.107837"},{"key":"S1463423625100698_ref7","unstructured":"Ministry of Health (2020) Prevalence of Diabetes Mellitus, Primary Care Clinical Database (BDCAP). Available at https:\/\/www.sanidad.gob.es\/estadEstudios\/estadisticas\/estadisticas\/estMinisterio\/SIAP\/3Prev_diabetes_mellitus.pdf (accessed 28 May 2025)."},{"key":"S1463423625100698_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2024.07.008"},{"key":"S1463423625100698_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmclc.2018.04.009"},{"key":"S1463423625100698_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2024.07.010"},{"key":"S1463423625100698_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2023.08.003"},{"key":"S1463423625100698_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2039"},{"key":"S1463423625100698_ref16","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S1463423625100698_ref8","unstructured":"Ministry of Health (2023) Number of nursing professionals working in the National Health System (SNS) in Primary Care by Autonomous Community. Available at https:\/\/www.sanidad.gob.es\/estadEstudios\/sanidadDatos\/tablas\/tabla14.htm (accessed 28 May 2025)."},{"key":"S1463423625100698_ref10","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep14020089"},{"key":"S1463423625100698_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2021.11.011"},{"key":"S1463423625100698_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"S1463423625100698_ref15","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000038674"}],"container-title":["Primary Health Care Research &amp; Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1463423625100698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T05:32:20Z","timestamp":1766986340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1463423625100698\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":16,"alternative-id":["S1463423625100698"],"URL":"https:\/\/doi.org\/10.1017\/s1463423625100698","relation":{},"ISSN":["1463-4236","1477-1128"],"issn-type":[{"value":"1463-4236","type":"print"},{"value":"1477-1128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e3"}}