Navigating continuity of post discharge care: Lived experiences of patients with diabetic foot ulcers in Ghana

Résumé fourni par la source

Background Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus, contributing to prolonged hospitalizations, lower-limb amputations, and mortality, particularly in low- and middle-income countries. Continuity of care following discharge is critical for wound healing and long-term outcomes, yet little is known about patients' experiences post-discharge in resource-limited settings. Objective To explore the post-discharge care experiences of patients with DFUs at Komfo Anokye Teaching Hospital, Ghana, with a focus on wound care, self-management, and system-level barriers. Methods This qualitative study involved in-depth interviews with 11 purposively sampled patients living with DFUs. Data were collected using a semi-structured interview guide and analysed using reflexive thematic analysis to identify key themes related to continuity of care after hospital discharge. Results Participants described a range of care experiences after discharge, including both facility-based and home-based wound dressing. However, the consistency and quality of care varied widely, with some reporting harmful practices due to poor supervision. Patients assumed major responsibility for self-care, including wound hygiene, medication adherence, and glycaemic control, but faced challenges related to financial hardship, lack of education, and limited access to professional care. Inadequate discharge education, inconsistent family support, and delays within the health system further disrupted care continuity. Conclusion Post-discharge care for DFU patients in Ghana is often fragmented and heavily dependent on patients' personal and informal support systems. To improve outcomes, there is an urgent need for coordinated discharge planning, standardized wound care protocols, and strengthened follow-up systems that support patients beyond the hospital setting.

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