{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:58:49Z","timestamp":1782316729168,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the feasibility, acceptability, and implementation of HEALing (Healing through Empowerment and Active Listening)\u2014a clinic\u2010integrated self\u2010care intervention delivered by trained wound care nurses in three 30\u2010min face\u2010to\u2010face sessions over 6\u2009weeks to support diabetic foot ulcer healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A mixed\u2010methods, single\u2010arm hybrid effectiveness\u2013implementation pilot and qualitative study was conducted. Feasibility was evaluated through enrolment, retention, attendance and data completeness; acceptability via qualitative interviews; and implementation by tracking intervention delivery time. Potential effectiveness was assessed through changes in psychological (illness beliefs, foot care confidence, diabetes distress, quality of life, autonomy support), behavioural (foot care practices), knowledge (of wound deterioation), and clinical (HbA1c) outcomes from baseline to 4\u2009weeks post intervention. Data were analysed using descriptive statistics, paired\u2010sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests and thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 29 individuals living with DFU participated in the study (response rate: 78%), with enrolment occurring between August and September 2024. Retention was 90% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200926). The average HEALing session lasted 32\u2009min (range: 15\u201350\u2009min). Statistically significant improvements were observed across psychological, behavioural, knowledge and clinical outcomes from baseline to post\u2010intervention (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005; Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.8\u20131.1). Qualitative findings reinforced the intervention's acceptability, highlighting how HEALing enhanced knowledge, emotional healing and empowerment through autonomy,fostering greater motivation and engagement in self\u2010care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot suggests the feasibility and acceptability of HEALing in nurse\u2010led DFU care, with preliminary indications of psychological and clinical benefits. The findings support the potential for scalable integration of psychological support, warranting further evaluation in larger, controlled trials with extended follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70187","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:17:37Z","timestamp":1767165457000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Healing through empowerment and active listening (\n                    <scp>HEALing<\/scp>\n                    ): A mixed\u2010methods evaluation of the feasibility and acceptability of a nurse\u2010led self\u2010care support intervention for people with diabetic foot ulcers"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-6203","authenticated-orcid":false,"given":"Xiaoli","family":"Zhu","sequence":"first","affiliation":[{"name":"NHG Polyclinics NHG Health  Singapore"},{"name":"Nanyang Technological University Lee Kong Chian School of Medicine  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-535X","authenticated-orcid":false,"given":"Eng Sing","family":"Lee","sequence":"additional","affiliation":[{"name":"Nanyang Technological University Lee Kong Chian School of Medicine  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-3422","authenticated-orcid":false,"given":"Frederick H. 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