The lived experience of active charcot foot in diabetes mellitus

Abstract

Charcot foot is a rare but potentially devastating complication of diabetes that can result in foot deformities, ulceration and potentially amputation. Offloading via non-removable cast for an average of nine months is the only known effective treatment. The impact of a clinical diagnosis of active Charcot foot and its management on patient’s quality of life has not been well studied. The aim of this research was to enhance the understanding of
the lived experience of individuals diagnosed with active Charcot foot.

A novel method of photo elicitation and qualitative interviews using Interpretive Phenomenological Analysis (IPA) was used for the study. Participants were asked to bring in three to five of their own photographs to demonstrate how the diagnosis and
management of active Charcot foot had affected their lives. These photographs were used as the basis of a discussion in a semi-structured, tape-recorded interview. Eight interviews were carried out with diabetic foot patients recently diagnosed with acute Charcot foot presenting to one clinical centre and undergoing treatment with casting therapy (six males and two females; two with type 1 and six with type 2 diabetes). The mean age was 59
years and the mean duration of diabetes was 16 years. Time from symptom onset to diagnosis ranged from three days to six months. Duration of casting therapy prior to the interviews ranged from three to seven months.

Patients identified several areas of concern including alterations to their experience of lived time, lived space and a loss of their sense of self. These have been explored through the following three master themes: the life journey interrupted, the hindered body in places and spaces and the diminishing self in a restricted lifeworld. It has therefore been recommended that practitioners take a more holistic approach to assessing and treating this patient group in line with both the results of this research and current government and NHS guidelines. This is the first study known to have explored the patient’s perspective of the lived experience of an active Charcot foot. It has demonstrated that both the diagnosis of an active Charcot foot and its management has a more severe impact on patient’s perceived quality of life and sense of well-being than has been suggested in previous research.

Date of Award	Aug 2019
Original language	English
Awarding Institution	University of Brighton
Supervisor	Simon Otter (Supervisor), Channine Clarke (Supervisor), Christopher Morriss-Roberts (Supervisor) & Adrian Bone (Supervisor)