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Treatment Delay in Patients With Diabetes-Related Foot Ulcers: A Walker and Avant Concept Analysis
Jinyan Zhou1, Yihong Xu1, Shanni Ding1
1Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Abstract:
Treatment delay is a critical yet inconsistently defined concept in diabetes-related foot ulcer (DFU) care, hindering comparability across studies and clinical interpretation. This study aimed to clarify the concept of treatment delay in patients with DFU using Walker and Avant's concept analysis method. Eleven databases (PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, ProQuest, CNKI, WanFang, VIP, SinoMed) were searched from inception to June 5, 2026. Peer-reviewed studies addressing DFU-related treatment delay were included. Twenty-four studies were analyzed. Two defining attributes were identified: (1) a temporally bounded interval from first awareness of a foot ulcer to initiation of guideline-concordant DFU care, and (2) normative excessiveness beyond a clinically acceptable timeframe. Patient delay and professional/system delay were identified as conceptual subtypes. Antecedents and consequences spanned patient, social, and healthcare system levels. This concept analysis clarifies the conceptual boundaries of treatment delay in patients with DFU and provides a foundation for standardized measurement and future intervention research.
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