Diabetes-Related Foot Ulcers: The Role of Informal Caregivers' Experiences and Needs Regarding Involvement in Multidisciplinary Team Treatment. A Qualitative Study.

Many informal caregivers rarely or never attended consultations and struggled to define involvement in practical terms.

• The study used focus group interviews and template analysis to identify patterns in caregivers' experiences, needs, and preferences.
• The setting was a highly specialised outpatient service with a multidisciplinary team structure that was still evolving.
• Despite low attendance at consultations, caregivers were still expected to support complex treatment regimens outside clinical settings.
• Caregivers had difficulty articulating what meaningful involvement would look like in practice.

Caregivers consistently expressed a strong wish for earlier involvement in care, ideally at the time of diabetes diagnosis.

• The preference for earlier involvement was described as a consistent pattern across caregiver participants.
• Caregivers wanted earlier involvement specifically to acquire the knowledge and skills needed to support patients between clinical visits.
• This finding suggests considerable potential to improve patient care through earlier caregiver involvement.
• The desired involvement extended beyond the point of foot ulcer development to the earlier stage of diabetes diagnosis.

Informal caregivers play an important role in foot ulcer management because complex treatment regimens require ongoing support outside clinical settings.

• Complex regimens identified as requiring caregiver support included wound care, offloading, and lifestyle adjustments.
• This support was needed between clinical visits, positioning caregivers as essential intermediaries in ongoing treatment.
• The multidisciplinary team structure in the outpatient service was described as 'still evolving' at the time of the study.
• Some caregivers reported positive experiences with their involvement in care.

Caregiver involvement in diabetes-related foot ulcer management was associated with emotional and practical burden, feelings of guilt, and uncertainty about roles.

• Participants described both emotional burden and practical burden as consequences of their caregiving role.
• Feelings of guilt were specifically identified as a theme among caregiver participants.
• Uncertainty about their roles was reported as a distinct source of difficulty for caregivers.
• The findings indicate that involvement may create strain, suggesting a need to balance benefits of involvement against the risk of caregiver burden.

The study identified the need for structured caregiver education, clear communication, and systemic support to address gaps in caregiver involvement.

• Structured caregiver education was highlighted as a specific unmet need in the current multidisciplinary team framework.
• Clear communication between the multidisciplinary team and caregivers was identified as lacking or insufficient.
• Systemic support was recommended to balance the benefits of caregiver involvement with the risk of caregiver burden.
• These recommendations were derived from focus group interviews analyzed using template analysis methodology.