title: Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy.
abstract: OBJECTIVE
  To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber.
  
  
  BACKGROUND
  To our knowledge there are no patients' evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given.
  
  
  METHODS
  Explorative study.
  
  
  METHODS
  Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44-83 years (median 70), with diabetic foot ulcers, participated.
  
  
  METHODS
  Focus-group interviews by an external evaluator.
  
  
  RESULTS
  Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation.
  
  
  CONCLUSIONS
  From patients' perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease.
authors.affiliation: Department of Community Medicine, University of Lund, Lund, Sweden. katarina.hjelm@vxu.se
authors.forename: Hjelm
authors.initials: H
authors.lastname: Katarina
authors.forename: Löndahl
authors.initials: L
authors.lastname: Magnus
authors.forename: Katzman
authors.initials: K
authors.lastname: Per
authors.forename: Apelqvist
authors.initials: A
authors.lastname: Jan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction