Health belief theories and their influence on adherence behaviours in individuals with diabetic foot ulceration: A literature review

Zainal, Nurul, Holloway, Samantha and Edney, Sian Marie 2021. Health belief theories and their influence on adherence behaviours in individuals with diabetic foot ulceration: A literature review. Journal of Wound Management 22 (2) , pp. 15-21. 10.35279/jowm202107.03

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Abstract

Background Existing evidence suggests that adherence to treatment plans and long-term lifestyle modifications could reduce costly complications associated with diabetes, such as diabetic foot ulcers (DFU). Applying biopsychosocial models and theories to practice can help clinicians understand why individuals adopt or reject certain health behaviours. Aims This review explores the dynamic between patients’ psychosocial behaviours and their levels of commitment to treatment plans, discusses approaches for improving the therapeutic relationship between health care professionals (HCPs) and patients through collaborative healthcare planning and raises awareness of the importance of identifying the psychological barriers to managing outcomes of chronic illnesses. Methods This is a narrative exploration of health belief theories applied to managing diabetes and DFU, including a discussion of ‘compliance’, ‘adherence’ and ‘concordance’; health psychology theories on adherence behaviours; and the role of emotional responses in influencing the acceptance of long-term treatments. Findings Evidence highlighted the role of psychosocial factors in influencing a person’s decision-making process and noted individual differences in the willingness to conform to certain health and treatment recommendations, based on prior assumptions and know-ledge extending beyond a longer-term conception of the benefits and risks of behaviours or disease progression. Conclusions Healthcare planning should shift from labelling patients as ‘non-compliant’ toward promoting collaborative conversations that inform choices and actions. HCPs should acknowledge the importance of patients’ knowledge and views about their health and create treatment plans that best suit these individual needs. Future research should develop health belief models to incorporate patients’ emotional responses to chronic illness.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	European Wound Management Association
ISSN:	2788-5771
Last Modified:	20 Feb 2026 16:20
URI:	https://orca.cardiff.ac.uk/id/eprint/185097

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