{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:10:29Z","timestamp":1779113429052,"version":"3.51.4"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Diabetic foot syndrome (DFS) can be prevented, but due to various obstacles preventive measures can only be implemented inadequately. Person\u2010centred care forms the foundation for effective support measures. However, the current lack of a longitudinal perspective on patients' Illness trajectory hinders the development and provision of tailored support. The aim was to describe the illness trajectory experienced by patients with DFS. To investigate the research question we used a qualitative design based on the \u2018Interpretive Description\u2019 and conducted a purposive sample of individual interviews in a university hospital's wound outpatient department. Data were analysed according to Braun and Clark's reflexive thematic analysis using the illness trajectory model as a theoretical framework. We included 12 patients with diabetic foot ulcers and recorded wound duration, number of ulceration recurrences and rate of amputation. We identified six illness trajectory\u2010relevant phases: (1) silent or non\u2010apparent diabetes mellitus (DM); (2) occurrence of the first wound: present DFS; (3) needing inpatient treatment; (4) from a mosquito emerges an elephant; (5) being in outpatient treatment and experiencing wound\u2010free periods and (6) the occurrence of recurrences. Participants stated both self\u2010management and care coordination behaviours regarding their treatment. However, due to knowledge gaps, misunderstandings or a desire for \u2018normalcy\u2019 and independence from the healthcare system as they juggled multiple comorbidity\u2010related responsibilities, they often acted contrary to behavioural recommendations. \u2018Silent diabetes\u2019 is not always prioritised in disease management.<\/jats:p>","DOI":"10.1111\/iwj.70159","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T02:08:45Z","timestamp":1743127725000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cI Never Thought They Would Ever Take Off My Toes\u201d: A Qualitative Illness Trajectory Study in People With Diabetic Foot Syndrome"],"prefix":"10.1111","volume":"22","author":[{"given":"Sina","family":"Lachappelle","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal System (ZMSI), Department for Orthopaedics and Traumas Surgery University Hospital Basel  Basel Switzerland"},{"name":"Institute for Nursing Science, Department Public Health University of Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Clauss","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal System (ZMSI), Department for Orthopaedics and Traumas Surgery University Hospital Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannette","family":"W\u00fcthrich","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal System (ZMSI), Department for Orthopaedics and Traumas Surgery University Hospital Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin","family":"Schick","sequence":"additional","affiliation":[{"name":"Institute for Nursing Science, Department Public Health University of Basel  Basel Switzerland"},{"name":"Department of Visceral Surgery and Medicine University Hospital of Bern  Bern Switzerland"},{"name":"Department of Health Professionals Bern University of Applied Science  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva\u2010Maria","family":"Panfil","sequence":"additional","affiliation":[{"name":"Institute for Nursing Science, Department Public Health University of Basel  Basel Switzerland"},{"name":"Department Practice Development and Research University Hospital Basel  Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"WHO \u201cDiabetes \u201d2020 https:\/\/www.who.int\/health\u2010topics\/diabetes#tab=tab_1."},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1284-6412"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v13.i1.27"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56080380"},{"key":"e_1_2_14_6_1","volume-title":"Diabetic Foot Ulcer","author":"Oliver T. I.","year":"2020"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13010"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13973"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13569"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v11.i9.391"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3257"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S146342362000064X"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2022.11.005"},{"key":"e_1_2_14_15_1","unstructured":"IWGDF \u201cGuidelines on the Prevention of Foot Ulcers in Persons With Diabetes \u201d2023 https:\/\/iwgdfguidelines.org\/wp\u2010content\/uploads\/2023\/07\/IWGDF\u20102023\u201002\u2010Prevention\u2010Guideline.pdf."},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1071\/AH13060"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14190"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2021.11.004"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2022.102493"},{"issue":"2","key":"e_1_2_14_20_1","article-title":"Psychological Interventions for Treating Foot Ulcers, and Preventing Their Recurrence, in People With Diabetes","volume":"2","author":"McGloin H.","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2023.06.001"},{"key":"e_1_2_14_22_1","unstructured":"World Health Organization WHO Global Strategy on People\u2010Centred and Integrated Health Services: Interim Report(World Health Organization 2015)."},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.11.004"},{"issue":"1","key":"e_1_2_14_24_1","first-page":"33","article-title":"The Corbin and Strauss Chronic Illness Trajectory Model: An Update","volume":"12","author":"Corbin J. M.","year":"1998","journal-title":"Scholarly Inquiry for Nursing Practice"},{"key":"e_1_2_14_25_1","volume-title":"Weiterleben lernen: Verlauf und Bew\u00e4ltigung chronischer Krankheit","author":"Corbin J. M.","year":"2010"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1055-3290(98)80078-2"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2012-000415"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315426259"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12583"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004723"},{"key":"e_1_2_14_32_1","unstructured":"\u201cDeutsches Netzwerk f\u00fcr Qualit\u00e4tsentwicklung in der Pflege. Kurzanleitung zum Wound\u2010QoL \u201d2015 https:\/\/www.dnqp.de\/fileadmin\/HSOS\/Homepages\/DNQP\/Dateien\/Expertenstandards\/Pflege_von_Menschen_mit_chronischen_Wunden\/ChronWu_Akt_Wound\u2010QoL_Kurzanleitung.pdf."},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2008.02352.x"},{"key":"e_1_2_14_34_1","first-page":"137","article-title":"Entwicklung und \u00dcberpr\u00fcfung des neu entwickelten Fragebogens, Frankfurter Aktivit\u00e4tenkatalog der Selbstpflege\u2013Pr\u00e4vention Diabetisches Fu\u00dfsyndrom (Kurzform: FAS\u2010Pr\u00e4DiFu\u00df)","volume":"14","author":"Schmidt S.","year":"2005","journal-title":"Diabetes Und Stoffwechsel: Zeitschrift f\u00fcr Angewandte Diabetologie"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-2779-6_103-1"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/ev.1427"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-2082-2"},{"key":"e_1_2_14_39_1","volume-title":"Pflege\u2010und Krankheitsverl\u00e4ufe aktiv steuern und bew\u00e4ltigen: unter Ber\u00fccksichtigung des Corbin\u2013Strauss\u2010Pflegemodells","author":"Gerwin B.","year":"2005"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1891\/0889-7182.5.3.197"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006205-199302000-00018"},{"key":"e_1_2_14_42_1","first-page":"45","article-title":"The Health Belief Model","volume":"4","author":"Champion V. L.","year":"2008","journal-title":"Health Behavior and Health Education: Theory, Research, and Practice"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318032937e"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109118"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13587"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11428-006-0037-7"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00440-w"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0088437"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2020.29.Sup9b.S1"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3105"},{"key":"e_1_2_14_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2019.01.004"},{"key":"e_1_2_14_52_1","unstructured":"IWGDF \u201cIWGDF Guidelines on the Prevention and Management of Diabetic Foot Disease \u201d2019 https:\/\/iwgdfguidelines.org\/wp\u2010content\/uploads\/2020\/06\/IWGDF\u2010Guidelines\u20102019_german.Vers_.2_20200625pdf.pdf."},{"key":"e_1_2_14_53_1","unstructured":"National Institute for Health and Care Excellence \u201cDiabetic Foot Problems: Prevention and Management \u201d2019 https:\/\/www.nice.org.uk\/guidance\/ng19\/chapter\/Recommendations#care\u2010within\u201024\u2010hours\u2010of\u2010a\u2010person\u2010with\u2010diabetic\u2010foot\u2010problems\u2010being\u2010admitted\u2010to\u2010hospital\u2010or\u2010the."},{"key":"e_1_2_14_54_1","volume-title":"Advanced Practice Nursing\u2010E\u2010Book: An Integrative Approach","author":"Hamric A. B.","year":"2013"},{"key":"e_1_2_14_55_1","unstructured":"Bundesamt f\u00fcr Gesundheit \u201cMedizinische Fusspflege: Bundesrat verbessert Zugang f\u00fcr Personen mit Diabetes \u201d2021 https:\/\/www.bag.admin.ch\/bag\/de\/home\/das\u2010bag\/aktuell\/medienmitteilungen.msg\u2010id\u201083681.html."},{"key":"e_1_2_14_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.foot.2021.101872"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T06:43:01Z","timestamp":1746427381000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,25]]},"references-count":55,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/iwj.70159"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70159","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,25]]},"assertion":[{"value":"2024-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70159"}}