Nutrition as an Overlooked Yet Critical Dimension in Outpatient Wound Care Practice: A Multicentre Qualitative Study

Despite strong evidence that nutrition is critical for wound healing, its integration into outpatient practice remains inconsistent. This study aimed to explore how nutrition is perceived, communicated, and experienced in outpatient wound care-encompassing healthcare professionals' clinical practice and professional reasoning, and patients' lived experiences. This multicentre qualitative study using Interpretive Description generated data through 156 h of field observations, five focus groups with nurses (n = 19), and interviews with patients with foot ulcers (n = 9) across six outpatient clinics in Denmark. Nutrition was acknowledged as fundamental to wound healing, yet communication remained brief, non-specific, and rarely actionable. Nurses adopted pragmatic, patient-adapted approaches shaped by unclear role responsibility, time constraints, and limited tools, resulting in opportunistic rather than systematic care. Patients had limited understanding of nutrition's role in wound healing, reflecting insufficient explanation rather than disengagement. Relational continuity and communication quality were determinants of whether nutrition became a meaningful component of care. Patients were willing to engage when advice was concrete and tailored to their everyday context. A persistent gap exists between the acknowledged importance of nutrition and its enactment in outpatient wound care, sustained by organisational, communicative, and role-related ambiguities, with implications for nursing education, interdisciplinary roles, and clinical pathways.