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A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample

AIM: To describe patients’ reported employment challenges associated with diabetic foot ulcers (DFUs). METHODS: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February...

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Autores principales: Palmer, Kelly N. B., Crocker, Rebecca M., Marrero, David G., Tan, Tze-Woei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140327/
https://www.ncbi.nlm.nih.gov/pubmed/37124466
http://dx.doi.org/10.3389/fcdhc.2023.1027578
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author Palmer, Kelly N. B.
Crocker, Rebecca M.
Marrero, David G.
Tan, Tze-Woei
author_facet Palmer, Kelly N. B.
Crocker, Rebecca M.
Marrero, David G.
Tan, Tze-Woei
author_sort Palmer, Kelly N. B.
collection PubMed
description AIM: To describe patients’ reported employment challenges associated with diabetic foot ulcers (DFUs). METHODS: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February 2021. Participants consented to an audio-recorded semi-structured phone interview. Interviews were transcribed and thematically analyzed using the Dedoose data analysis platform. RESULTS: Participants shared a common theme around the cyclic challenges of DFU prevention/management and employment. Those employed in manual labor-intensive jobs or jobs requiring them to be on their feet for long durations of time believed working conditions contributed to the development of their DFUs. Patients reported work incapacity due to declines in mobility and the need to offload for DFU management. Many expressed frustration and emotional distress related to these challenges noting that DFUs resulted in lower remuneration as medical expenses increased. Consequently, loss of income and/or medical insurance often hindered participants’ ability to manage DFUs and subsequent complications. CONCLUSION: These data illuminate the vicious cycle of DFU and employment challenges that must be addressed through patient-centered prevention strategies. Healthcare providers should consider a person’s contextual factors such as employment type to tailor treatment approaches. Employers should establish inclusive policies that support patients with DFUs returning to work through flexible working hours and adapted work tasks as needed. Policymakers can also mitigate employment challenges by implementing social programs that provide resources for employees who are unable to return to work in their former capacity.
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spelling pubmed-101403272023-04-29 A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample Palmer, Kelly N. B. Crocker, Rebecca M. Marrero, David G. Tan, Tze-Woei Front Clin Diabetes Healthc Clinical Diabetes and Healthcare AIM: To describe patients’ reported employment challenges associated with diabetic foot ulcers (DFUs). METHODS: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February 2021. Participants consented to an audio-recorded semi-structured phone interview. Interviews were transcribed and thematically analyzed using the Dedoose data analysis platform. RESULTS: Participants shared a common theme around the cyclic challenges of DFU prevention/management and employment. Those employed in manual labor-intensive jobs or jobs requiring them to be on their feet for long durations of time believed working conditions contributed to the development of their DFUs. Patients reported work incapacity due to declines in mobility and the need to offload for DFU management. Many expressed frustration and emotional distress related to these challenges noting that DFUs resulted in lower remuneration as medical expenses increased. Consequently, loss of income and/or medical insurance often hindered participants’ ability to manage DFUs and subsequent complications. CONCLUSION: These data illuminate the vicious cycle of DFU and employment challenges that must be addressed through patient-centered prevention strategies. Healthcare providers should consider a person’s contextual factors such as employment type to tailor treatment approaches. Employers should establish inclusive policies that support patients with DFUs returning to work through flexible working hours and adapted work tasks as needed. Policymakers can also mitigate employment challenges by implementing social programs that provide resources for employees who are unable to return to work in their former capacity. Frontiers Media S.A. 2023-04-14 /pmc/articles/PMC10140327/ /pubmed/37124466 http://dx.doi.org/10.3389/fcdhc.2023.1027578 Text en Copyright © 2023 Palmer, Crocker, Marrero and Tan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Clinical Diabetes and Healthcare
Palmer, Kelly N. B.
Crocker, Rebecca M.
Marrero, David G.
Tan, Tze-Woei
A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title_full A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title_fullStr A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title_full_unstemmed A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title_short A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample
title_sort vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized southwest us sample
topic Clinical Diabetes and Healthcare
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140327/
https://www.ncbi.nlm.nih.gov/pubmed/37124466
http://dx.doi.org/10.3389/fcdhc.2023.1027578
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