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Title: Factors Influencing the Management of Diabetic Foot Ulcers Among Healthcare Professionals at the Primary Healthcare Level in Bosomtwe District, Ghana
Background: The incidence of diabetes is increasing in low- and middle-income countries (LMICs), with many cases undiagnosed until complications such as diabetic foot ulcers (DFUs) occur. Effective DFU management requires a multidisciplinary approach involving various healthcare professionals (HCPs). This study assessed the factors influencing DFU management among HCPs in the Bosomtwe District, Ghana.
Methods: A cross-sectional study using a quantitative approach was conducted in three purposively selected health facilities. A total of 231 respondents were recruited through simple random sampling. Data were collected using pretested, self-administered questionnaires and analyzed with descriptive and inferential statistics in STATA version 16.
Results: The majority of participants were registered nurses (71%), and no podiatrist was available in the district. Although 69.5% of respondents demonstrated general knowledge of DFU management, most lacked specific knowledge of dressings and offloading devices. Nearly all respondents (99.7%) did not use evidence-based guidelines due to the absence of a universal protocol. Regular consultation of guidelines was strongly associated with better DFU management outcomes (p < 0.001, OR = 0.36, CI = 0.17–0.72). Key challenges included poor adherence to guidelines by HCPs (p = 0.001, OR = 0.03, CI = 0.04–0.22), patient non-compliance with treatment (p < 0.001, OR = 0.04, CI = 0.02–0.81), and low diagnostic confidence among HCPs (p < 0.001, OR = 0.65, CI = 0.55–0.76).
Conclusion: Significant gaps exist in DFU management at the primary care level, particularly regarding adherence to evidence-based guidelines, diagnostic confidence, and patient compliance. Standardized protocols, targeted capacity-building for HCPs, and enhanced patient education are essential to improve outcomes in DFU care.
Keywords: Diabetic foot ulcers, healthcare professionals, primary healthcare, evidence-based practice