The lived reality of diabetic foot ulcers: a systematic review and meta-synthesis on patients' experiences and coping for a high-quality life

糖尿病足溃疡患者的真实生活:关于患者经历和应对方式以实现高质量生活的系统评价和荟萃分析

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Abstract

BACKGROUND: Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus, leading to infection, amputation, and reduced quality of life. Beyond their clinical impact, DFUs impose psychological, social, and economic burdens on affected individuals. Despite extensive research on DFU prevention and management, the lived experiences of those suffering from DFUs remain underexplored. Understanding these experiences is essential for improving patient-centered interventions and holistic care approaches. METHODS: A systematic review and meta-synthesis of qualitative studies were conducted following PRISMA and ENTREQ guidelines. A comprehensive search was performed in PubMed, CINAHL, PsycINFO, Scopus, and Web of Science from 2020 to 2024. Studies were selected based on the SPIDER framework, focusing on adults with DFUs and their lived experiences. Noblit and Hare's meta-ethnographic approach was used to synthesize data, identifying first-, second-, and third-order constructs. Thematic synthesis was applied to extract key challenges, coping strategies, and resilience factors from the included studies. RESULTS: The analysis included 27 studies with 576 participants and identified four uplifting themes: (1) Rising Above Daily Challenges with DFUs, showing how people stay active, turn struggles into strengths, and care for their feet with pride; (2) Moving Forward Through Uncertainty and Connection, highlighting hope, teamwork with others, and efforts to find helpful information; (3) Embracing a New Way of Living, reflecting creative solutions, joy in fresh starts, and welcoming support; and (4) Growing Stronger with Purpose and Support, capturing personal growth and building encouraging relationships. These themes reveal the many ways participants shine through their experiences. CONCLUSION: This meta-synthesis underscores the complex, multifaceted impact of DFUs beyond the physical wound, emphasizing the necessity of holistic, patient-centered care. Enhancing communication, addressing psychosocial challenges, and integrating support systems can improve outcomes and quality of life for DFU patients. Future research should focus on culturally tailored interventions and longitudinal studies to track resilience over time. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-025-01726-1.

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