{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:55:11Z","timestamp":1787748911099,"version":"build-2784847793"},"reference-count":38,"publisher":"Wiley","issue":"23-24","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To assess primary healthcare professionals\u2019 priority for managing diabetic foot disease (DFD) over the progressive course of the condition compared to other aspects of diabetes care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>DFD affects up to 60 million people globally. Evidence suggests that comprehensive preventative footcare may reduce serious complications of DFD, such as amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross\u2010sectional quantitative study reported according to STROBE statement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>General Practitioners (GPs) and Credentialled Diabetes Educators (CDEs) working within Australian primary care were invited to complete an online survey, to obtain information about preventative and early intervention footcare priorities and practices. Ten GPs and 84 CDEs completed the survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On diagnosis of type 2 diabetes, haemoglobin A1c (HbA1c) review was identified to be one of the top three priorities of care by 57 (61%) of participants whilst at 20\u2010year history of diabetes 73 (78%) participants indicated its priority. Foot assessments became a priority for 78% (<jats:italic>n<\/jats:italic>\u00a0=\u00a073) of participants and podiatry referrals a priority for 53% (<jats:italic>n<\/jats:italic>\u00a0=\u00a050) of participants only when a \u201cfoot concern\u201d was raised. Referrals to specialist high\u2010risk foot podiatrists or services were a first priority for 56% (<jats:italic>n<\/jats:italic>\u00a0=\u00a053), when the person had significant amputation risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diabetes\u2010related preventative footcare assessments and management remain a low priority amongst primary healthcare professionals. Preventative care for asymptomatic complications, such as DFD, may be overlooked in favour of monitoring HbA1c or medication management. Limited prioritisation of footcare in primary care is concerning given the risks for amputation associated with DFD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>This study reveals the need for primary healthcare decision makers and clinicians to ensure preventative footcare is a focused priority earlier in the diabetes care continuum. Collaborative and widespread promotion of the importance of proactive rather than reactive footcare practices is required to support prevention of foot ulcers and amputation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15506","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T21:24:18Z","timestamp":1600723458000},"page":"4653-4673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prioritisation of diabetes\u2010related footcare amongst primary care healthcare professionals"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0182-2148","authenticated-orcid":false,"given":"Leanne","family":"Mullan","sequence":"first","affiliation":[{"name":"Deakin University School of Nursing and Midwifery Geelong Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-7691","authenticated-orcid":false,"given":"Karen","family":"Wynter","sequence":"additional","affiliation":[{"name":"Deakin University School of Nursing and Midwifery Geelong Vic. Australia"},{"name":"Centre for Quality and Patient Safety Deakin University Geelong Australia"},{"name":"Western Health Partnership St. Albans Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6837-0249","authenticated-orcid":false,"given":"Andrea","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Deakin University School of Nursing and Midwifery Geelong Vic. Australia"},{"name":"Centre for Quality and Patient Safety Deakin University Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6789-8260","authenticated-orcid":false,"given":"Bodil","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Deakin University School of Nursing and Midwifery Geelong Vic. Australia"},{"name":"Centre for Quality and Patient Safety Deakin University Geelong Australia"},{"name":"Western Health Partnership St. Albans Vic. Australia"},{"name":"Faculty of Health and Medical Sciences Copenhagen Denmark"},{"name":"Faculty of Health Sciences University of Southern Denmark and Steno Diabetes Center Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/2251-6581-11-24"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_12_4_1","volume-title":"What is credentialling?","author":"Australian Diabetes Educators Association","year":"2018"},{"key":"e_1_2_12_5_1","volume-title":"Initial credentialling \u2013 Become a Credentialled Diabetes Educator","author":"Australian Diabetes Educators Association","year":"2018"},{"key":"e_1_2_12_6_1","volume-title":"Australian National Diabetes Audit: Australian Quality Clinical Audit 2018 Annual Report","author":"Australian Government Department of Health","year":"2018"},{"key":"e_1_2_12_7_1","volume-title":"Australian National Diabetes Audit: Australian Quality Clinical Audit 2019 Annual Report","author":"Australian Government Department of Health","year":"2019"},{"key":"e_1_2_12_8_1","volume-title":"Primary health care","author":"Australian Institute of Health and Welfare","year":"2018"},{"key":"e_1_2_12_9_1","volume-title":"Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015","author":"Australian Institute of Health and Welfare","year":"2019"},{"key":"e_1_2_12_10_1","first-page":"151","article-title":"The new prognostic\u2010therapeutic index for diabetic foot surgery\u2010extended analysis","volume":"111","author":"Bobirca F.","year":"2016","journal-title":"Chirurgia"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0744"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1520-7560(200009\/10)16:1 <::AID-DMRR105>3.0.CO;2-N"},{"issue":"1","key":"e_1_2_12_13_1","first-page":"33","article-title":"The Diabetic Foot","volume":"43","author":"Boulton A. J. M.","year":"2014","journal-title":"Medicine Journal"},{"issue":"1","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":":e3269","DOI":"10.1002\/dmrr.3269","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (International Working Group on the Diabetic Foot 2019 update)","volume":"36","author":"Bus S. A.","year":"2020","journal-title":"Diab Metab Res Rev"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2738"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2696"},{"key":"e_1_2_12_17_1","volume-title":"Barriers to diabetic foot care","author":"Clayton\u2010Jones M.","year":"2015"},{"key":"e_1_2_12_18_1","volume-title":"How does Australian diabetes foot screening rate on an international stage?","author":"Davis A.","year":"2014"},{"issue":"1","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1186\/s12913-015-1043-5","article-title":"Barriers to diabetic foot care in a developing country with a high incidence of diabetes related amputations: an exploratory qualitative interview study","volume":"15","author":"Guell C.","journal-title":"BMC Health Services Research"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1757-1146-7-30","article-title":"The assessment and management of diabetes related lower limb problems in India\u2010an action research approach to integrating best practice","volume":"7","author":"Harrison\u2010Blount M.","year":"2014","journal-title":"Journal of Foot and Ankle Research"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2238"},{"key":"e_1_2_12_22_1","volume-title":"IDF clinical practice recommendations on the diabetic foot \u2013 2017: A guide for health care professionals","author":"International Diabetes Federation","year":"2017"},{"key":"e_1_2_12_23_1","volume-title":"International Diabetes Federation Diabetes Atlas 9th Edition 2019","author":"International Diabetes Federation","year":"2019"},{"key":"e_1_2_12_24_1","volume-title":"The Diabetic Foot","author":"International Diabetes Federation","year":"2020"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13973"},{"issue":"8","key":"e_1_2_12_26_1","first-page":"36","article-title":"Are practices nurses equipped to do diabetic foot assessments?","volume":"114","author":"Lakha T.","year":"2018","journal-title":"Nursing Times (online)"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2005.02.010"},{"issue":"11","key":"e_1_2_12_28_1","first-page":"e008544","article-title":"Prevalence of foot disease and risk factors in general inpatient populations: A systematic review and meta\u2010analysis","volume":"5","author":"Lazzarini P. A.","year":"2015","journal-title":"British Medical Journal Open"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY19115"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY19183"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13653"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2017.1305891"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1462399409000945"},{"key":"e_1_2_12_34_1","volume-title":"What is general practice?","author":"Royal Australian College of General Practitioners","year":"2020"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3266"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1303"},{"key":"e_1_2_12_37_1","volume-title":"Primary health care in Australia","author":"The Department of Health","year":"2013"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.7547\/0003-0538-104.4.387"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.15506","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocn.15506","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.15506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T17:25:18Z","timestamp":1696699518000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocn.15506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,5]]},"references-count":38,"journal-issue":{"issue":"23-24","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/jocn.15506"],"URL":"https:\/\/doi.org\/10.1111\/jocn.15506","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,5]]},"assertion":[{"value":"2020-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}