{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:03:22Z","timestamp":1790136202519,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"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":["Nursing &amp; Health Sciences"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Treatment delay is a critical yet inconsistently defined concept in diabetes\u2010related foot ulcer (DFU) care, hindering comparability across studies and clinical interpretation. This study aimed to clarify the concept of treatment delay in patients with DFU using Walker and Avant's concept analysis method. Eleven databases (PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, ProQuest, CNKI, WanFang, VIP, SinoMed) were searched from inception to June 5, 2026. Peer\u2010reviewed studies addressing DFU\u2010related treatment delay were included. Twenty\u2010four studies were analyzed. Two defining attributes were identified: (1) a temporally bounded interval from first awareness of a foot ulcer to initiation of guideline\u2010concordant DFU care, and (2) normative excessiveness beyond a clinically acceptable timeframe. Patient delay and professional\/system delay were identified as conceptual subtypes. Antecedents and consequences spanned patient, social, and healthcare system levels. This concept analysis clarifies the conceptual boundaries of treatment delay in patients with DFU and provides a foundation for standardized measurement and future intervention research.<\/jats:p>","DOI":"10.1111\/nhs.70397","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:44:11Z","timestamp":1785239051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Delay in Patients With Diabetes\u2010Related Foot Ulcers: A Walker and Avant Concept Analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4853-3282","authenticated-orcid":false,"given":"Jinyan","family":"Zhou","sequence":"first","affiliation":[{"name":"Nursing Department Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-8316","authenticated-orcid":false,"given":"Yihong","family":"Xu","sequence":"additional","affiliation":[{"name":"Nursing Department Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0097-2200","authenticated-orcid":false,"given":"Shanni","family":"Ding","sequence":"additional","affiliation":[{"name":"Nursing Department Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5597-1793","authenticated-orcid":false,"given":"Hongying","family":"Pan","sequence":"additional","affiliation":[{"name":"Nursing Department Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8309.1995.tb01047.x"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2021.30.10.804"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3647"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3651"},{"issue":"3","key":"e_1_2_15_7_1","first-page":"190","article-title":"Current Situation Research of Health \u2043 Seeking Delay and It's Influence on Treatment Outcome in Diabetic Foot Patients","volume":"30","author":"Cao Q.","year":"2022","journal-title":"Chinese Journal of Diabetes"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3644"},{"issue":"6","key":"e_1_2_15_9_1","first-page":"128","article-title":"Correlation Between Treatment Delay and Health Belief in Diabetic Foot Patients","volume":"40","author":"Chen X.","year":"2022","journal-title":"Health Vocational Education"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.05.006"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000913"},{"issue":"11","key":"e_1_2_15_12_1","first-page":"865","article-title":"A Qualitative Study to Analyse the Reasons for Delayed Medical Treatment in Diabetic Foot Patients Based on a Health Ecology Model","volume":"39","author":"Dong Y.","year":"2023","journal-title":"Chinese Journal of Practical Nursing"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14139"},{"issue":"1","key":"e_1_2_15_14_1","first-page":"14","article-title":"An Investigation Into Why Expert Assessment of New Diabetic Foot Ulcers Is Delayed","volume":"25","author":"Gorman A. D.","year":"2022","journal-title":"Diabetic Foot Journal"},{"key":"e_1_2_15_15_1","volume-title":"Idf Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"issue":"5","key":"e_1_2_15_16_1","first-page":"345","article-title":"Treatment Delay and Its Predictors in Patients With Diabetic Foot Ulcers","volume":"21","author":"Li X.","year":"2022","journal-title":"Chinese Journal of Multiple Organ Diseases in the Elderly"},{"issue":"2","key":"e_1_2_15_17_1","first-page":"114","article-title":"Analysis of Related Factors of Treatment Delay in Patients With Diabetic Foot","volume":"9","author":"Li Y.","year":"2017","journal-title":"China Continuing Medical Education"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12030761"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01721-x"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.244"},{"key":"e_1_2_15_21_1","volume-title":"Diabetic Foot Problems: Prevention and Management (NICE Guideline NG19)","author":"National Institute for Health and Care Excellence","year":"2015"},{"key":"e_1_2_15_22_1","first-page":"443","article-title":"The Culpability for Delay in the Treatment of Cancer","volume":"33","author":"Pack G. T.","year":"1938","journal-title":"American Journal of Cancer"},{"issue":"1","key":"e_1_2_15_23_1","first-page":"142","article-title":"Analysis of the Status Quo and Related Factors of Treatment Delay in 183 Patients With Diabetic Foot in a Hospital","volume":"36","author":"Qin Y.","year":"2018","journal-title":"Journal of Preventive Medicine of Chinese People's Liberation Army"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.09.016"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3687"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00395-y"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010022\u201000561\u20104"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3654"},{"key":"e_1_2_15_30_1","volume-title":"Strategies for Theory Construction in Nursing","author":"Walker L. O.","year":"2011"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2011.010113"},{"issue":"3","key":"e_1_2_15_32_1","first-page":"387","article-title":"Investigation of Medical Delays in the Elderly With Diabetic Foot Ulcers","volume":"25","author":"Wang Z.","year":"2019","journal-title":"Geriatrics & Health Care"},{"issue":"12","key":"e_1_2_15_33_1","first-page":"1701","article-title":"Status and Influencing Factors of Delay in Seeking Medical Treatment of Diabetic Foot Patients","volume":"26","author":"Wu H.","year":"2020","journal-title":"International Medicine and Health Guidance News"},{"issue":"1","key":"e_1_2_15_34_1","first-page":"81","article-title":"Analysis of Delayed Treatment Status and Influencing Factors of 52 Patients With Diabetic Foot in a Third\u2010Grade Hospital of XPCC","volume":"22","author":"Xia Y.","year":"2024","journal-title":"Journal of Bingtuan Medicine"},{"key":"e_1_2_15_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2088"},{"key":"e_1_2_15_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/19386400211067625"},{"key":"e_1_2_15_37_1","volume-title":"Medical Psychology","author":"Yao S.","year":"2013"},{"issue":"32","key":"e_1_2_15_38_1","first-page":"4055","article-title":"Analysis of Clinical Characteristics of Delayed Treatment in Elderly Diabetic Foot Patients","volume":"17","author":"Zhang C.","year":"2019","journal-title":"Chinese General Practice Nursing"},{"issue":"34","key":"e_1_2_15_39_1","first-page":"4717","article-title":"Correlation Between Pre\u2010Hospital Delay and Illness Perception in Patients With Diabetic Foot","volume":"18","author":"Zhang C.","year":"2020","journal-title":"Chinese General Practice Nursing"},{"issue":"5","key":"e_1_2_15_40_1","first-page":"567","article-title":"Analysis of Pre\u2010Hospital Delay and Its Influencing Factors in Patients With Diabetic Foot","volume":"51","author":"Zhang C.","year":"2016","journal-title":"Chinese Journal of Nursing"},{"issue":"9","key":"e_1_2_15_41_1","first-page":"29","article-title":"Effect of Pre\u2010Hospital Delay in Patients With Diabetic Foot on Treatment Outcome","volume":"27","author":"Zhang C.","year":"2020","journal-title":"Modern Nurse"},{"key":"e_1_2_15_42_1","first-page":"7","article-title":"The Status and Influencing Factors of Delayed Treatment in Diabetic Foot Patients","volume":"1","author":"Zhao H.","year":"2023","journal-title":"Medicine & Health"},{"key":"e_1_2_15_43_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2023.0284"}],"container-title":["Nursing &amp; Health Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nhs.70397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:10:45Z","timestamp":1790133045000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nhs.70397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/nhs.70397"],"URL":"https:\/\/doi.org\/10.1111\/nhs.70397","archive":["Portico"],"relation":{},"ISSN":["1441-0745","1442-2018"],"issn-type":[{"value":"1441-0745","type":"print"},{"value":"1442-2018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70397"}}