{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:25:41Z","timestamp":1772166341470,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":316,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":316,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001787","name":"University of South Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001787","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study is to extend on our previous research by exploring patient\u2010perceived factors that lead to their Lower Extremity Amputations (LEA). LEA are a serious complication of Type 2 Diabetes Mellitus (T2DM), LEA are thought to be preventable with early detection and management of risk factors. Our previous study identified that these factors extend beyond the typical biological and modifiable risk factors and may also extend to patient awareness and competing priorities. Therefore, this research explored these issues in further detail, identifying patient\u2010perceived factors that lead to their LEA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative descriptive methodology involving non\u2010probability purposive sampling was used to recruit inpatients at a tertiary metropolitan hospital in South Australia. Semi\u2010structured interviews were conducted, and data were transcribed verbatim. Data from the interviews were analysed using thematic analysis and the constant comparison approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15 participants shared their perspectives of risk factors for LEA. Two main themes emerged: intrinsic and extrinsic factors. Intrinsic factors identified in this study included identity, ambivalence, denial, inevitability, and helplessness. Extrinsic factors related to resources, rapport with healthcare professionals, and management of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Through identifying that a combination of perceived personal attributes (intrinsic) and system\u2010level (extrinsic) factors likely contribute to LEA, this study highlights the complexity of factors that contribute to patients\u2019 perceptions of what led to their diabetes related LEA. These findings support the importance of a nuanced approach in managing patients with diabetes who are at risk of LEA as it's likely patients' personal circumstances, day\u2010to\u2010day life's requirements and responsibilities, their interaction with healthcare professionals all seemingly contribute to how risks are viewed and managed. Tackling this challenge will require reimagining diabetes care, acknowledgement of risk factors beyond the obvious and addressing persistent access and workforce issues.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13047-023-00675-3","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T02:02:16Z","timestamp":1699840936000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cI know what I'm supposed to do, but I don't do it\u201d: patient\u2010perceived risk factors that lead to their lower extremity amputations"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6869-0074","authenticated-orcid":false,"given":"Marcelle","family":"Ben chmo","sequence":"first","affiliation":[{"name":"Allied Health &amp; Human Performance The University of South Australia North Terrace 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Matricciani","sequence":"additional","affiliation":[{"name":"Clinical and Health Sciences The University of South Australia North Terrace 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saravana","family":"Kumar","sequence":"additional","affiliation":[{"name":"Allied Health &amp; Human Performance The University of South Australia North Terrace 5000 Adelaide SA Australia"},{"name":"Innovation IMPlementation and Clinical Translation (IIMPACT in Health) The University of South Australia North Terrace 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Graham","sequence":"additional","affiliation":[{"name":"Allied Health &amp; Human Performance The University of South Australia North Terrace 5000 Adelaide SA Australia"},{"name":"Innovation IMPlementation and Clinical Translation (IIMPACT in Health) The University of South Australia North Terrace 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12404"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.10.010"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102016\u2010000366"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239236"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.304"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107996"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102014\u2010000069"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170705"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182081"},{"key":"e_1_2_12_11_1","unstructured":"Services Australia.What health care is covered by Medicare how to enrol and how to claim. Australian Government.https:\/\/www.servicesaustralia.gov.au\/medicare. Accessed 20 Jan 2023."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.279"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010022\u201000589\u20106"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010022\u201000556\u20101"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S146342362000064X"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13010"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182081"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1098\u2010240X(200008)23:4<334::AID\u2010NUR9>3.0.CO;2\u2010G"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.21768"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010021\u201000457\u20109"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S54457"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0286468"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2012.677936"},{"issue":"5","key":"e_1_2_12_25_1","first-page":"1189","article-title":"Enhancing the quality and credibility of qualitative analysis","volume":"34","author":"Patton MQ","year":"1999","journal-title":"Health Serv Res"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524839915580941"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1035719X0600600108"},{"key":"e_1_2_12_28_1","volume-title":"Qualitative research methods","author":"Liamputtong P","year":"2013"},{"issue":"163","key":"e_1_2_12_29_1","first-page":"105","article-title":"Competing paradigms in qualitative research","volume":"2","author":"Guba EG","year":"1994","journal-title":"Handb Qual Res"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475\u20109276\u201012\u201018"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY16093"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010018\u20105637\u20109"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-66873-0_4"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1188\/04.ONF.985\u2010988"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010021\u201000447\u2010x"},{"key":"e_1_2_12_36_1","unstructured":"WellbeingSA.Lower limb amputations in South Australia. Government of South Australia.https:\/\/www.sahealth.sa.gov.au\/wps\/wcm\/connect\/public+content\/sa+health+internet\/about+us\/wellbeing+sa\/wellbeing+sa. Accessed 30 Feb 2023."},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sintl.2021.100117"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18063014"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819a5acc"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2019.05.010"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010021\u201000684\u20102"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14199"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010018\u20100784\u2010z"}],"container-title":["Journal of Foot and Ankle Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13047-023-00675-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13047-023-00675-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13047-023-00675-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1186\/s13047-023-00675-3","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T02:16:11Z","timestamp":1745460971000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1186\/s13047-023-00675-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1186\/s13047-023-00675-3"],"URL":"https:\/\/doi.org\/10.1186\/s13047-023-00675-3","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3196177\/v1","asserted-by":"object"}]},"ISSN":["1757-1146","1757-1146"],"issn-type":[{"value":"1757-1146","type":"print"},{"value":"1757-1146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"assertion":[{"value":"23 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval for this study was obtained from the Central Adelaide Local Health Network Human Research Ethics Committee (CALHN HREC), protocol 13611 and the Human Research Ethics Committee, University of South Australia, protocol 203444. No incentives were provided for participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Non applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}