Sister Julia Zhu
Senior Nurse Clinician, Nursing Services, NHG Polyclinics
Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus that place significant physical, psychological, and financial burden on patients. While effective self-care is crucial for DFU management, adherence remains suboptimal. DFUs are often viewed merely as wounds to treat and close. However, through experience, Sister Julia Zhu has come to recognise them as more than just clinical conditions — they are stories of struggle, resilience, and silence.
As a Senior Wound Nurse Clinician from NHG Polyclinics and PhD candidate with the Lee Kong Chian School of Medicine (LKCMedicine), Sister Zhu’s journey has been shaped not only by what she observes in wounds, but also by voices of those living with them. These insights became the foundation of her doctoral research. Through a mixed-methods approach, she explored how psychological factors – including diabetes distress, self-efficacy, and perceived control – influence self-care among individuals with DFUs. Yet identifying barriers was merely the beginning. She felt compelled to go further – to co-create better solutions with patients, rather than simply for them.
Under the mentorship of Associate Professor Konstadina Griva (Associate Professor of Health Psychology/ Behavioural Medicine, LKCMedicine) and support from NHG Polyclinics Nursing Services, Sister Zhu spearheaded the co-design of HEALing – Healing through Empowerment and Active Listening.
Developed using an Experience-Based Co-Design framework, HEALing brought together patients, clinicians, and researchers to shape a programme grounded in lived experience. Rooted in Self-Determination Theory and Motivational Interviewing, HEALing fosters connection, autonomy, and resilience. Its pilot – a hybrid effectiveness-implementation study – yielded promising results. Participants reported improved psychological and clinical outcomes, and, most significantly, felt truly heard for the first time.
This journey presented numerous challenges – balancing clinical duties with academic research, and navigating behaviour change in a field traditionally driven by biomedical priorities. Entering behavioural science and psychology was uncharted territory. Nevertheless, Sister Zhu was guided by a deep conviction: patients’ voices offer vital, often overlooked insights. Despite being stretched while learning new methodologies and remaining active on the frontlines, her belief in the value of this work never wavered. Instead, it reinforced her resolve. She discovered that meaningful change begins when patients feel genuinely seen and heard. What continues to inspire her are the intimate, powerful moments of connection – particularly those shared during co-design sessions and post-HEALing interviews:
“Living with a foot wound is tough, but I’m not alone. There’s someone I can talk to and share with.”
“Your nurses were trained to listen and understand how we feel, and to talk with us about how our wounds affect us.”
“People usually do not want to change because change is painful! HEALing made me a better person. It empowered me to change.”
These stories confirmed a fundamental truth: addressing the psychological dimensions of chronic illness is not optional – it is essential. They remind Sister Zhu why she chose this path – to create spaces where healing begins not just with clinical care, but through human connection, empowerment, and the profound experience of being seen and supported.
“Patient stories remind me why I choose this path – to create spaces where healing begins not just with clinical care, but through human connection, empowerment and the profound experience of being seen and supported.”
In February 2025, HEALing received the Best Diabetic Foot Intervention Award from the Journal of Wound Care. Beyond being a clinical accolade, it validated what was possible when patients, clinicians, and researchers co-design care. That same year, Sister Zhu was honoured with the 2025 Early Career Award in Behavioural Medicine from the International Society of Behavioural Medicine – a recognition that further affirmed the impact of bridging psychological science and clinical nursing. These milestones underscored the transformative power of holistic models that support the whole person – mind and body – through empathy, collaboration, and shared purpose.
