Endocrinologists’ Perspectives on Early Screening for Diabetic Peripheral Neuropathy: A Phenomenological Study in Four Chinese Based Hospitals

Haili Zhu,1,2 Wanting Xie,3,* Xueqin Zeng,3,* Qing Yuan,3,* Dong Zhu,3 Ouying Chen,3 Yan Chen21School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China; 2Office of Research Affairs,Hunan Academy of Chinese Medicine, Changsha, Hunan, People’s Republic of China; 3School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yan Chen, Office of Research Affairs, Hunan Academy of Chinese Medicine, No. 142 Yuehua Road, Yuelu District, Changsha, Hunan, 410013, People’s Republic of China, Tel +86 13874867790, Email 17773910461@163.com; Ouying Chen, School of Nursing, Hunan University of Chinese Medicine, No. 200 Xueshi Road, Yuelu District, Changsha, Hunan, 410208, People’s Republic of China, Tel +86 13687373957, Email 13687373957@163.comPurpose: This study aims to explore endocrinologists’ awareness and current practices regarding early screening for diabetic peripheral neuropathy (DPN), and to further analyze their experiences, barriers, and potential optimization strategies in implementing DPN screening within clinical practice.Patients and Methods: Methods: A qualitative study based on Husserl’s phenomenological framework was conducted. Twelve endocrinologists (3 male, 9 female; age range 29– 47 years; clinical experience 3– 23 years) from four tertiary hospitals in China were recruited via purposive sampling. Semi-structured in-depth interviews were used. This phenomenological approach was chosen to explore the lived experiences and subjective perceptions of physicians regarding DPN screening, as quantitative methods cannot capture such contextual richness. Data were analyzed using NVivo 20.0 with Colaizzi’s seven-step method.Results: Five major themes and 11 sub-themes were identified: The most predominant finding was that, despite endocrinologists’ recognition of the necessity and urgency of early DPN screening, its implementation is critically limited by three interrelated barriers: insufficient physician training and heavy workloads, limitations of screening tools (eg subjectivity of physical exams and high cost of electromyography), and poor patient compliance due to lack of awareness and financial constraints.Other themes included current screening practices and optimization strategies.Conclusion: This study indicates that despite the critical role of early DPN screening in diabetes management, its implementation remains constrained by limited healthcare resources, limitations of screening tools, and patient-related barriers, such as awareness and affordability. Therefore, it is recommended to enhance physician training, standardize screening protocols, and improve patient adherence through policy support and health education to promote the widespread adoption of DPN screening.Keywords: endocrinologist, diabetic peripheral neuropathy, early screening, perspectives, phenomenological study, qualitative research