{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:07:34Z","timestamp":1789106854816,"version":"build-2803163510"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Diabetic foot ulcers (DFUs) are a leading cause of preventable amputation worldwide. Patient misconceptions and poor circulatory awareness are underrecognized drivers of delayed presentation in Saudi Arabia. This study aimed to assess DFU-related misconceptions, circulatory awareness, and health-seeking behavior, and identify predictors of delayed care-seeking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted between February and April 2026 among 574 adult diabetic patients attending 11 outpatient facilities in Riyadh, Saudi Arabia. A validated structured questionnaire assessed misconceptions, circulation awareness, health-seeking behavior, and prior education sources. Descriptive statistics,\n                      <jats:italic>t<\/jats:italic>\n                      -tests, ANOVA, chi-square, Pearson correlation, and binary logistic regression were applied; significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean misconception score was 3.04\u202f\u00b1\u202f0.34 (scale 1\u20135); 55.6% indicated a wound warrants attention only when painful, 65.0% stated they would delay care for a painless blister, and 50.7% would wait for pain before treating a painless ulcer. Circulation awareness averaged 3.25\u202f\u00b1\u202f0.38; only 28.4% adequately distinguished nerve damage from circulatory impairment. Only 45.6% had received structured foot care education, while internet or social media (61.9%) outranked healthcare providers (35.9%) as the primary information source. Male sex (OR\u202f=\u202f1.536, 95% CI 1.092\u20132.161,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014) and longer diabetes duration (OR\u202f=\u202f1.258, 95% CI 1.049\u20131.509,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014) were the only independent predictors of high delay propensity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Saudi diabetic patients demonstrated substantial DFU misconceptions and delay propensity, with pain-centric beliefs and inadequate formal education as key contributing factors. Structured, circulation-focused patient education within primary and family medicine settings may help address delayed presentation and support amputation prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1924054","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:30:20Z","timestamp":1789104620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Misconceptions and health-seeking behavior among diabetic patients regarding foot ulcers: the hidden role of circulatory awareness in preventing amputation"],"prefix":"10.3389","volume":"14","author":[{"given":"Abdulaziz Fahd","family":"AlKaabba","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazeed","family":"AlHarbi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fayez Zaben","family":"Al-Mutairi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz Sulaiman","family":"Alshaya","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Fahd bin","family":"Jassas","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris Saleh","family":"Alkahtani","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Abdullah","family":"Al-Subaie","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal Mohammed","family":"Alaswad","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"AlOtaibi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman Omar","family":"Almesned","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahaf Naji","family":"Almutairi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU)","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"ref1","volume-title":"IDF Diabetes Atlas","year":"2021"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s12933-020-01184-4","article-title":"Diabetes and COVID-19 among hospitalized patients in Saudi Arabia: a single-centre retrospective study","volume":"19","author":"Alguwaihes","year":"2020","journal-title":"Cardiovasc Diabetol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1056\/NEJMra1615439","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","journal-title":"N Engl J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1080\/07853890.2016.1231932","article-title":"Global epidemiology of diabetic foot ulceration: a systematic review and 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