Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China

Abstract Diabetic foot ulcers [DFUs] are severe complications of diabetes, and therapeutic footwear plays a crucial role in their prevention. However the factors influencing adherence to therapeutic among high-risk individuals in urban areas remain poorly understood. With increasing urbanization and...

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Main Authors: Wangqiao Zhu, Liuxue Lu, Lifang Huang, Sulan Long, Lina Ou, Meng Yang, Yongxian Wei, Yanfang Lu, Yunjiao Tang, Jia Liu
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-06323-z
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author Wangqiao Zhu
Liuxue Lu
Lifang Huang
Sulan Long
Lina Ou
Meng Yang
Yongxian Wei
Yanfang Lu
Yunjiao Tang
Jia Liu
author_facet Wangqiao Zhu
Liuxue Lu
Lifang Huang
Sulan Long
Lina Ou
Meng Yang
Yongxian Wei
Yanfang Lu
Yunjiao Tang
Jia Liu
author_sort Wangqiao Zhu
collection DOAJ
description Abstract Diabetic foot ulcers [DFUs] are severe complications of diabetes, and therapeutic footwear plays a crucial role in their prevention. However the factors influencing adherence to therapeutic among high-risk individuals in urban areas remain poorly understood. With increasing urbanization and migrant workers, this study aims to explore the challenges of adherence to therapeutic footwear among high-risk diabetic foot patients in urban area. This study employed a qualitative descriptive design. Data were collected through semi-structured interviews and focus group discussions, and analyzed using a thematic approach. A total of 25 participants (20 patients and 5 healthcare providers) were recruited through purposive sampling. Two key challenges of footwear adherence were identified: (1) inadequacy of consistent and reliable health resources, and (2) appearance-related barriers to footwear adherence: professionalism, fashion, and social perception. Participants reported inconsistent and unreliable health information, including confusion from online sources and varied hospital guidance, which reduced their confidence in wearing therapeutic footwear. Additionally, appearance-related barriers—such as workplace dress codes, fashion preferences, and fear of social judgment—discouraged use of therapeutic footwear in both professional and social settings. This study highlights the need to integrate social and functional elements into the design of therapeutic footwear. Nursing professionals play a critical role in enhancing communication and coordination around foot care. Enhancing access to reliable health information is essential for promoting DFU prevention, particularly among urban migrant populations.
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spelling doaj-art-e10670c76682485dbe929c1a06b00b3b2025-08-20T03:45:23ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-06323-zAdherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest ChinaWangqiao Zhu0Liuxue Lu1Lifang Huang2Sulan Long3Lina Ou4Meng Yang5Yongxian Wei6Yanfang Lu7Yunjiao Tang8Jia Liu9Faculty of Nursing, Youjiang Medical University for NationalitiesAffiliated Hospital of Youjiang Medical University for NationalitiesAffiliated Hospital of Youjiang Medical University for NationalitiesFaculty of nursing, Nanchang Medical CollegeAffiliated Hospital of Youjiang Medical University for NationalitiesAffiliated Hospital of Youjiang Medical University for NationalitiesBaise People’s HospitalAffiliated Hospital of Youjiang Medical University for NationalitiesAffiliated Hospital of Youjiang Medical University for NationalitiesFaculty of Nursing, Youjiang Medical University for NationalitiesAbstract Diabetic foot ulcers [DFUs] are severe complications of diabetes, and therapeutic footwear plays a crucial role in their prevention. However the factors influencing adherence to therapeutic among high-risk individuals in urban areas remain poorly understood. With increasing urbanization and migrant workers, this study aims to explore the challenges of adherence to therapeutic footwear among high-risk diabetic foot patients in urban area. This study employed a qualitative descriptive design. Data were collected through semi-structured interviews and focus group discussions, and analyzed using a thematic approach. A total of 25 participants (20 patients and 5 healthcare providers) were recruited through purposive sampling. Two key challenges of footwear adherence were identified: (1) inadequacy of consistent and reliable health resources, and (2) appearance-related barriers to footwear adherence: professionalism, fashion, and social perception. Participants reported inconsistent and unreliable health information, including confusion from online sources and varied hospital guidance, which reduced their confidence in wearing therapeutic footwear. Additionally, appearance-related barriers—such as workplace dress codes, fashion preferences, and fear of social judgment—discouraged use of therapeutic footwear in both professional and social settings. This study highlights the need to integrate social and functional elements into the design of therapeutic footwear. Nursing professionals play a critical role in enhancing communication and coordination around foot care. Enhancing access to reliable health information is essential for promoting DFU prevention, particularly among urban migrant populations.https://doi.org/10.1038/s41598-025-06323-zDiabetesInformationTherapeutic footwearUrbanChina
spellingShingle Wangqiao Zhu
Liuxue Lu
Lifang Huang
Sulan Long
Lina Ou
Meng Yang
Yongxian Wei
Yanfang Lu
Yunjiao Tang
Jia Liu
Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
Scientific Reports
Diabetes
Information
Therapeutic footwear
Urban
China
title Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
title_full Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
title_fullStr Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
title_full_unstemmed Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
title_short Adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban Southwest China
title_sort adherence challenges to therapeutic footwear among high risk diabetic foot populations in urban southwest china
topic Diabetes
Information
Therapeutic footwear
Urban
China
url https://doi.org/10.1038/s41598-025-06323-z
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