Podiatrists\u2019 views of assessment and management of pain in diabetes-related foot ulcers: a focus group study

Nicoletta Frescos,Bev Copnell

doi:10.1186/s13047-020-00399-8

Nicoletta Frescos, Bev Copnell

Open Access

https://doi.org/10.1186/s13047-020-00399-8

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Abstract

BackgroundContrary to the belief that patients with diabetes-related foot ulcers (DRFU) do not experience wound related pain due to the presence of peripheral neuropathy there is increasing evidence that pain can be present. Subsequently, wound-related pain is often underestimated and undertreated. The aim of this study is to describe what influences pain assessment of DRFU.MethodsA qualitative exploratory study was conducted with podiatrists who managed DRFU. Eight podiatrists were recruited through a professional organisation to participate in a focus group. A thematic analysis was conducted to identify themes that explored the barriers and enablers to pain assessment and management of DRFU.ResultsThree themes emerged. Observational and non-verbal cues were the preferred approaches used to assess wound pain. Assumptions and value judgments of the pain patients experienced and the relationships between podiatrists, patients and other health care practitioners were important influencers on the assessment and management of pain.ConclusionThe perceived barriers to the assessment and management of wound related pain in DRFU were attitudes and beliefs about pain, lack of DRFU-specific validated assessment tools and lack of knowledge and skills to manage the pain.

Highlights

Wounds caused by the pathological processes of diabetes mellitus have in the past been described as usually non-painful it is becoming more evident that people with diabetic foot wounds can experience wound-related pain [1,2,3,4]
The complexity of DFRU and the characteristics of wound pain associated with diabetes-related foot ulcers (DRFU) impacts on accurate pain assessment [2]
Participants A total of eight podiatrists who worked in various clinical work settings for high-risk foot clinics attended the focus group

Summary

Introduction

Wounds caused by the pathological processes of diabetes mellitus have in the past been described as usually non-painful it is becoming more evident that people with diabetic foot wounds can experience wound-related pain [1,2,3,4]. Studies have shown that up to 75% of people with diabetic foot ulcers experience wound-related pain [2, 3, 7,8,9,10]. Contrary to the belief that patients with diabetes-related foot ulcers (DRFU) do not experience wound related pain due to the presence of peripheral neuropathy there is increasing evidence that pain can be present. The aim of this study is to describe what influences pain assessment of DRFU

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