"Don't Sugar Coat It" : An Interpretive Phenomenological Analysis of the Knowledge, Experiences and Perceptions of Diabetes-Related Complications in a Population with Diabetic Foot Ulcers

  • Claire James-Fleming

Student thesis: Doctoral ThesisProfessional Doctorate (ProfD)


The aim of this study was to explore the knowledge and experiences of diabetes related complications in people with active diabetic foot ulceration (DFU). The method used was Interpretive Phenomenological Analysis (IPA) (Smith et ah, 2009) which was underpinned with the philosophy of Hans-Georg Gadamer.

Participants (n=6) were purposively recruited from the three acute-based diabetic foot clinics within NHS Lanarkshire in keeping with the method of IPA. Focused, but unstructured interviews were carried out, recorded, and transcribed verbatim. Second interviews with follow-up questions generated by initial findings from the first interviews were conducted in the same manner. Data were analysed using the six-steps of IPA (Smith et ah, 2009).

Themes emerged through this six-step process and use of the hermeneutic circle. Three superordinate themes emerged. These were: “Talking different languages”, “Psychological impact”, and“Reality of Chronicity”. Participants identified issues around communication with health care professionals (HCPs). Some felt as if they were being spoken down to or “told off’. Some did not understand what was being advised. There were also positive examples of communication. The themes of “following the rules” and “difficulty with diet” emerged as a challenging aspects of living with diabetes. Participants described issues with maintaining employment due to diabetes and one recalled a difficult time financially and described a loss of identity, and suicidal thoughts as a result.Themes of fear and regret were also identified. Participants expressed the desire to have had sufficient knowledge prior to developing complications to allow them to make lifestyle changes to prevent their occurrence.

Diabetes is a life altering condition and impacts on many aspects of life including employment and social events. It was clear that the traditional medical model still dominates despite emphasis on the person-centred care approach. HCP need to be able to enter in a partnership of care with patients so that there can be a better understanding in both parties and ultimately better clinical outcomes.
Date of Award2018
Original languageEnglish
Awarding Institution
  • Glasgow Caledonian University
SupervisorYvonne Robb (Supervisor) & Brian Ellis (Supervisor)

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