For older adults with recurrent diabetic foot ulceration, the shared experiential structure was continuing vulnerability after healing, alongside efforts to preserve control, autonomy and dignity.
Key Findings
Results
The shared essential structure of recurrent diabetic foot ulceration in adults aged 65 or older was continuing vulnerability after healing, alongside efforts to preserve control, autonomy and dignity.
Descriptive phenomenological design with 17 purposively recruited participants aged 65 years or older.
Recurrence was experienced as reshaping bodily confidence, everyday functioning, independence and future expectations.
Data were analysed inductively using Colaizzi's seven-step method.
Results
Four themes were identified from the interviews.
Theme 1: navigating recurrence: varied recognition, interpretations and responses.
Theme 2: pain and altered sensation: functional limitations and social participation.
Theme 3: living under the threat of amputation: distress, difficult decisions and acceptance.
Theme 4: relying on support while striving to preserve autonomy and dignity.
Results
Participants varied in how they recognised, interpreted and responded to ulcer recurrence.
This was captured in the theme 'navigating recurrence'.
The abstract frames recognition of recurrence as something care should assess.
Results
Pain and altered sensation limited function and social participation in older adults with recurrent diabetic foot ulcers.
This was captured in the theme 'pain and altered sensation: functional limitations and social participation'.
The authors recommend assessing sensory changes, pain and mobility.
Results
Older adults lived under the threat of amputation, experiencing distress, difficult decisions and eventual acceptance.
This was captured in theme 3.
The authors recommend assessing psychological distress and supporting shared decision-making.
Results
Participants relied on support from others while trying to preserve their autonomy and dignity.
This was captured in theme 4.
The authors recommend supporting rehabilitation, continuity of care and autonomy.
Conclusions
The authors concluded that care for older adults with recurrent diabetic foot ulceration should extend beyond wound management.
Recommended supports: shared decision-making, rehabilitation, continuity of care and autonomy.
Findings are said to inform nursing and multidisciplinary care across settings.
Methods
The study recruited from a single multidisciplinary diabetic foot clinic in China, with interviews between October 2025 and February 2026, and limited participant review of findings.
Individual semi-structured interviews were conducted with 17 participants.
Three participants subsequently reviewed a summary of the themes and shared essential structure.
Patients were not involved as research partners in design or conduct; the study adhered to the Consolidated Criteria for Reporting Qualitative Research.
What This Means
This study interviewed 17 adults aged 65 or older in China who had repeated diabetic foot ulcers. The researchers wanted to understand what it is like to live with ulcers that come back after healing. Interviews were analysed to find common patterns in what people described.
The central finding was that healing did not bring relief from vulnerability. Participants described a continuing sense of risk after a wound closed, along with efforts to keep control, independence and dignity. Four themes emerged: people differed in how they noticed and responded to recurrence; pain and changed sensation limited daily activities and social life; the threat of amputation brought distress and hard decisions; and people depended on others while trying to maintain autonomy.
This research suggests that care for older adults with recurrent foot ulcers may need to go beyond treating the wound. The authors point to attention to how people recognise recurrence, sensation changes, pain, mobility and emotional distress, as well as shared decision-making, rehabilitation and continuity of care. As a small qualitative study from a single clinic, it describes experiences rather than measuring how common they are.
Zhang S, Qin W, Fu Y, Ming Y, Fan H, Liu Z, et al.. (2026). The Lived Experience of Older Adults With Recurrent Diabetic Foot Ulcers: Empirical Research Qualitative.. Nursing open. https://doi.org/10.1002/nop2.70941