Student Profile: A Clinician’s Mission to Transform Diabetic Wound Care

By Sanjay Devaraja, Editor, LKCMedicine's Redefine Newsletter

We cast the spotlight on Ms Julia Zhu Xiaoli, a final-year PhD candidate at LKCMedicine under Associate Professor Konstadina Griva. A Senior Nurse Clinician at NHG Polyclinics specialising in wound care, she delivers advanced wound care for patients with complex wounds, guides the wound care team, and upholds the standards of wound care in the polyclinics. Her roles and responsibilities at NHG Polyclinics encompass patient care, teaching, and research.

Ms Zhu’s research examines barriers and facilitators in diabetic foot ulcer management, and involves co-designing and evaluating an integrated self-care support intervention to enhance patient experiences and outcomes. She was recently recognised for her research on diabetic foot ulcers (DFU) and its focus on patient empowerment and psychological adjustment to support DFU healing. Her PhD research is an example of patients, practitioners and researchers coming together to advance clinical practice.

We speak to Ms Zhu on how her clinical experience with diabetic foot ulcer patients shaped her PhD research into the psychological factors influencing wound healing, and what drives her passion for empowering patients in their self-care journeys.

What inspired you to focus your PhD research on diabetic foot ulcers (DFU)?

My decade-long experience as a senior wound nurse clinician led me to focus my PhD research on diabetic foot ulcers (DFUs). Through direct patient care, I observed that despite optimal wound treatment, many patients struggle with healing and experienced frequent recurrence. What particularly intrigue me is the apparent connection between patients' psychological state and their wound healing outcomes. I notice that those experiencing high levels of diabetes-related distress often showed poorer adherence to treatment and worse outcomes. This observation reveals a crucial gap in our traditional wound care approach, which primarily focuses on physical management while overlooking psychological aspects. This insight inspired my research into how psychological factors, particularly illness beliefs and diabetes distress, influence healing outcomes and quality of life in DFU patients.

What are some challenges in bridging research with clinical practice in wound care?

I view the challenges in bridging research with clinical practice in wound care as opportunities. My clinical experience opened the door to opportunities for research to be effectively adapted to meet diverse patient needs, particularly for those with multiple comorbidities and varying circumstances. Healthcare settings are increasingly developing robust systems for knowledge sharing and outcome measurement, enabling seamless integration of research findings into daily practice. Through structured implementation frameworks, we aim to effectively translate research evidence into clinical care.

How do you see your research influencing future DFU treatment approaches?

My research on barriers and enablers in DFU management has the potential to transform future treatment approaches. Through understanding patients' challenges and needs, we have developed a patient-centred intervention to enhance self-management support. Our integrated self-care support intervention serves as a model for comprehensive DFU care, aiming to improve patient engagement, treatment adherence, and clinical outcomes.

As a Senior Nurse Clinician, how do you balance patient care with academic research?

Balancing patient care with academic research demands strategic time management and clear priorities. I dedicate specific time blocks for research while ensuring clinical care remains paramount. Integration is key—I align research activities with clinical practice by using patient observations to inform research questions. Strong support networks, including management teams, collaborative colleagues and understanding academic supervisors, prove essential. This dual role creates a symbiotic relationship where clinical insights shape research direction, while research findings enhance patient care delivery. The challenge lies not in separating these roles, but in leveraging their complementary nature to advance both clinical practice and academic knowledge.

How has LKCMedicine shaped your career?

LKCMedicine's commitment to research excellence has provided me access to cutting-edge facilities and interdisciplinary approaches, while expert mentorship strengthened my research capabilities. The School's emphasis on translational research and clinical-academic integration helped me develop crucial skills in balancing clinical duties with research pursuits. Through regular seminars, collaborative opportunities, and support for conference presentations, LKCMedicine has fostered my professional growth and enhanced my ability to contribute meaningfully to healthcare advancement. This supportive environment has been fundamental in developing my capacity to bridge clinical practice with innovative research, enabling meaningful contributions to both the knowledge field and patient care advancement.

What is your advice to prospective and graduating students?

My advice to prospective and graduating students centres on three key aspects: clarity of purpose, practical application, and continuous growth. First, be clear about your goals and understand how further education aligns with your career aspirations. Strong time management skills and academic preparation are essential for balancing work and studies. Second, actively seek opportunities to implement research findings in clinical practice and maintain connections with your academic network. Finally, commit to continuous professional development through ongoing learning, collaboration, and mentorship opportunities. While combining clinical practice with academic pursuits is challenging, maintaining work-life balance and staying passionate about improving patient care will sustain you. Remember that challenges are learning opportunities, and success comes from remaining focused yet adaptable.

Please share more on your clinician-researcher journey.

My journey as a clinician-researcher has yielded valuable insights beyond academic findings. Working with DFU patients has taught me that behind every wound lies a unique story in their healing journey, and these personal narratives have profoundly enriched my research understanding. The impact of wound care research extends far beyond individual patient care, influencing family support systems, treatment protocols, clinical education, and healthcare policy. This PhD journey has taught me crucial lessons about resilience, the value of mentorship, and the importance of professional networks. Most significantly, it has reinforced my conviction that the integration of clinical practice with research creates powerful opportunities to advance wound management and enhance patient care outcomes.