The experiences of professional footcare among adults living with type 2 diabetes in Switzerland: a qualitative study

Background: Foot ulceration is a common complication of type 2 diabetes, which can lead to amputations and earlier mortality. National footcare guidelines recommend routine foot surveillance, preventative self-management patient education and prompt referral to professional footcare services when complications occur. However, little is known about how people living with type 2 diabetes experience diabetes footcare in Switzerland. The aim of this study was to explore the experiences of people living with type 2 diabetes who are at high risk for foot complications, when accessing and using professional footcare, in the context of the Swiss healthcare system. Method: Individual, in-depth semi-structured telephone interviews were conducted with adults with type 2 diabetes (n = 9) recruited from two regional hospitals and two primary care practices in the German-speaking region of Switzerland. Data were analysed thematically using Framework Analysis. Results: Three themes with subthemes were generated from the data: 1) footcare, the neglected component of diabetes management; 2) perceived roles of healthcare professionals; and 3) signposting within the healthcare system. The findings illustrated ambiguity and lack of consistency in the provision of services, which do not always align to national guidelines, as well as a lack of clarity of the roles of healthcare professionals in relation to diabetic footcare. Conclusion: The experiences of participants in this study highlight the need for increased awareness and new ways of working, including alignment to national guidelines and a clarification of the roles and responsibilities of multidisciplinary healthcare professionals, including general practitioners, diabetes nurses and specialist podiatrists within primary care in Switzerland.