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Suglo JN, Winkley K, Sturt J. Improving foot self-care in people with diabetes in Ghana: A development and feasibility randomised trial of a context appropriate, family-orientated diabetic footcare intervention. PLoS One 2024; 19:e0302385. [PMID: 38718093 PMCID: PMC11078378 DOI: 10.1371/journal.pone.0302385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/29/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Africa presents a higher diabetic foot ulcer prevalence estimate of 7.2% against global figures of 6.3%. Engaging family members in self-care education interventions has been shown to be effective at preventing diabetes-related foot ulcers. This study culturally adapted and tested the feasibility and acceptability of an evidence-based footcare family intervention in Ghana. METHODS The initial phase of the study involved stakeholder engagement, comprising Patient Public Involvement activities and interviews with key informant nurses and people with diabetes (N = 15). In the second phase, adults at risk of diabetes-related foot ulcers and nominated caregivers (N = 50 dyads) participated in an individually randomised feasibility trial of the adapted intervention (N = 25) compared to usual care (N = 25). The study aimed to assess feasibility outcomes and to identify efficacy signals on clinical outcomes at 12 weeks post randomisation. Patient reported outcomes were foot care behaviour, foot self-care efficacy, diabetes knowledge and caregiver diabetes distress. RESULTS Adjustments were made to the evidence-based intervention to reflect the literacy, information needs and preferences of stakeholders and to develop a context appropriate diabetic foot self-care intervention. A feasibility trial was then conducted which met all recruitment, retention, data quality and randomisation progression criteria. At 12 weeks post randomisation, efficacy signals favoured the intervention group on improved footcare behaviour, foot self-care efficacy, diabetes knowledge and reduced diabetes distress. Future implementation issues to consider include the staff resources needed to deliver the intervention, family members availability to attend in-person sessions and consideration of remote intervention delivery. CONCLUSION A contextual family-oriented foot self-care education intervention is feasible, acceptable, and may improve knowledge and self-care with the potential to decrease diabetes-related complications. The education intervention is a strategic approach to improving diabetes care and prevention of foot disease, especially in settings with limited diabetes care resources. Future research will investigate the possibility of remote delivery to better meet patient and staff needs. TRIAL REGISTRATION Pan African Clinical Trials Registry (PACTR) - PACTR202201708421484: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=19363 or pactr.samrc.ac.za/Search.aspx.
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Affiliation(s)
- Joseph Ngmenesegre Suglo
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
- Department of Nursing and Midwifery, Presbyterian University, Agogo, Ghana
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
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Rodrigues D, Silva R, Castanheira S, Carvalho L, Pinto C. Needs of Family Caregivers of People with Lower Limb Amputations: A Scoping Review. Behav Sci (Basel) 2024; 14:326. [PMID: 38667125 PMCID: PMC11047372 DOI: 10.3390/bs14040326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Lower limb amputation affects several parameters of a patient's life. Family caregivers providing care for these patients experience multiple feelings and needs; knowing caregivers' needs is essential to prepare them for this new role, as well as the health planning of this type of care. This scoping review aimed to identify and map the needs of family caregivers of people with lower limb amputations. This scoping review was conducted in accordance with the JBI methodological framework and the PRISMA-ScR reporting guidelines. A bibliographical search was carried out on the needs of family caregivers of lower limb amputees in 15 databases. Two independent reviewers extracted data using a data extraction tool developed for this scoping review. Eight studies were included in the present review (n = 6 quantitative studies; n = 2 reviews). Results indicate that family caregivers of people with lower limb amputations may experience an extensive range of needs, as follows: (i) mental health and psychological support, (ii) physical health, (iii) health and well-being, (iv) supportive care, (v) social support, and (vi) educational/informational support. The needs identified in this review can help to develop interventions and programs that provide better support during the situational transition process.
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Affiliation(s)
- Diana Rodrigues
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- ICBAS—Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Rosa Silva
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
| | | | - Luís Carvalho
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Cristina Pinto
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
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3
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Hançerlioğlu S, Toygar İ, Ayhan A, Yilmaz İ, Orhan Y, Özdemir GS, Şimşir IY, Çetinkalp Ş. Burden of Diabetic Foot Patients' Caregivers and Affecting Factors: A Cross-Sectional Study. INT J LOW EXTR WOUND 2023; 22:680-686. [PMID: 34338563 DOI: 10.1177/15347346211036530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
With the increase in the diabetic foot patients in recent decades, the caregivers of diabetic foot patients increase too. Most of these caregivers are informal caregivers. However, the studies examining the burden of the caregivers and affecting factors are limited. This study was conducted to determine the burden of the caregivers of diabetic foot patients and affecting factors. This cross-sectional study was conducted between the January and October 2020 in a diabetic foot council of a university hospital. Zarit Caregiver Burden Scale and a participant identification form were used for data collection. Most of the caregivers were female (75.2%) and the mean age was 51.27 ± 11.48 years. The burden of the caregivers was at moderate level in the current study. Factors affecting the caregivers' burden were caregivers' age, patients' family structure, caregivers' education level, caregivers' income level, hours per week spending for the care of the patients, and lack of choice.
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Affiliation(s)
| | | | | | | | - Yavuz Orhan
- Dokuz Eylül University Hospital, Izmir, Turkey
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4
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Huang Y, Hu J, Xie T, Jiang Z, Ding W, Mao B, Hou L. Effects of home-based chronic wound care training for patients and caregivers: A systematic review. Int Wound J 2023; 20:3802-3820. [PMID: 37277908 PMCID: PMC10588341 DOI: 10.1111/iwj.14219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/21/2023] [Indexed: 06/07/2023] Open
Abstract
We aimed to review and synthesise the evidence of the interventions of patients' and informal caregivers' engagement in managing chronic wounds at home. The research team used a systematic review methodology based on an updated guideline for reporting systematic reviews (PRISMA) and recommendations from the Synthesis Without Meta-analysis. Cochrane Central Register of Controlled Trial of the Cochrane Library, Pubmed, Embase, CINAHL, Wanfang (Chinese), and CNKI database (Chinese) were searched from inception to May 2022. The following MESH terms were used: wound healing, pressure ulcer, leg ulcer, diabetic foot, skin ulcer, surgical wound, educational, patient education, counselling, self-care, self-management, social support, and family caregiver. Experimental studies involving participants with chronic wounds (not at risk of wounds) and their informal caregivers were screened. Data were extracted and the narrative was synthesised from the findings of included studies. By screening the above databases, 790 studies were retrieved, and 16 met the inclusion and exclusion criteria. Studies were 6 RCTs and ten non-RCTs. Outcomes of chronic wound management included patient indicators, wound indicators, and family/caregiver indicators. Home-based interventions of patients or informal caregivers' engagement in managing chronic wounds at home may effectively improve patient outcomes and change wound care behaviour. What's more, educational/behavioural interventions were the primary type of intervention. Multiform integration of education and skills training on wound care and aetiology-based treatment was delivered to patients and caregivers. Besides, there are no studies entirely targeting elderly patients. Home-based chronic wound care training was important to patients with chronic wounds and their family caregivers, which may advance wound management outcomes. However, the findings of this systematic review were based on relatively small studies. We need more exploration of self and family-oriented interventions in the future, especially for older people affected by chronic wounds.
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Affiliation(s)
- Yao Huang
- Wound Healing Center at Emergency DepartmentNinth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
- Department of GraduateShanghai Jiao Tong University School of NursingShanghaiChina
| | - Jiale Hu
- Department of Nurse AnesthesiaVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Ting Xie
- Wound Healing Center at Emergency DepartmentNinth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhaoqi Jiang
- Wound Healing Center at Emergency DepartmentNinth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wenjing Ding
- Department of libraryShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Beiqian Mao
- Wound Healing Center at Emergency DepartmentNinth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Lili Hou
- Nursing DepartmentNinth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
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Wang X, Dai S, Zheng W, Chen W, Li J, Chen X, Zhou S, Yang R. Identification and verification of ferroptosis-related genes in diabetic foot using bioinformatics analysis. Int Wound J 2023; 20:3191-3203. [PMID: 37249237 PMCID: PMC10502281 DOI: 10.1111/iwj.14198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/02/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Ferroptosis is a novel form of cell death that plays a key role in several diseases, including inflammation and tumours; however, the role of ferroptosis-related genes in diabetic foot remains unclear. Herein, diabetic foot-related genes were downloaded from the Gene Expression Omnibus and the ferroptosis database (FerrDb). The least absolute shrinkage and selection operator regression algorithm was used to construct a related risk model, and differentially expressed genes were analysed through immune infiltration. Finally, we identified relevant core genes through a protein-protein interaction network, subsequently verified using immunohistochemistry. Comprehensive analysis showed 198 genes that were differentially expressed during ferroptosis. Based on functional enrichment analysis, these genes were primarily involved in cell response, chemical stimulation, and autophagy. Using the CIBERSORT algorithm, we calculated the immune infiltration of 22 different types of immune cells in diabetic foot and normal tissues. The protein-protein interaction network identified the hub gene TP53, and according to immunohistochemistry, the expression of TP53 was high in diabetic foot tissues but low in normal tissues. Accordingly, we identified the ferroptosis-related gene TP53 in the diabetic foot, which may play a key role in the pathogenesis of diabetic foot and could be used as a potential biomarker.
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Affiliation(s)
- Xiaoxiang Wang
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | - Shangtai Dai
- Medical schoolKunming University of Science and Technology, The First People's Hospital of Yunnan ProvinceKunmingChina
| | - Wenlian Zheng
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | - Wentao Chen
- The First Clinical Medical CollegeGuangdong Medical UniversityZhanjiangChina
| | - Jiehua Li
- Department of DermatologyThe First People's Hospital of FoshanFoshanChina
| | - Xiaodong Chen
- Department of Burn Surgery and Skin RegenerationThe First People's Hospital of FoshanFoshanChina
| | - Sitong Zhou
- Department of DermatologyThe First People's Hospital of FoshanFoshanChina
| | - Ronghua Yang
- Department of Burn and Plastic Surgery, Guangzhou First People's HospitalSouth China University of TechnologyGuangzhouChina
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Doss ER, Popejoy LL. Informal Family Caregiving of Patients with Diabetic Extremity Wounds: An Integrative Review. West J Nurs Res 2023; 45:272-281. [PMID: 35919019 DOI: 10.1177/01939459221115694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Annually, 26 million people worldwide develop diabetic extremity wounds, adversely impacting the lives of patients and their family caregivers, who provide vital health assistance to these patients. This integrative review synthesized scientific literature of informal caregiving experiences for patients with diabetic extremity wounds. Five databases were searched for relevant English-language quantitative or qualitative research; ten studies were included in the final analysis. The caregiving experience included disrupted routines, frustration, guilt, poor health care communication, helplessness, and anxiety. Increased caregiver burden and decreased quality of life were associated with higher patient amputation level, worsening wound appearance and patient pain, poor health care communication, lack of social support and/or caregiving help, and lack of caregiver employment outside the home. Future research opportunities include further exploration of caregiver tasks and priorities, caregiving experiences in settings lacking family support structures and equitable health system access, and relationships between the caregiver experience and patient health system utilization.
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7
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Bundó M, Vlacho B, Llussà J, Bobé I, Aivar M, Ciria C, Martínez-Sánchez A, Real J, Mata-Cases M, Cos X, Dòria M, Viade J, Franch-Nadal J, Mauricio D. Prediction of outcomes in subjects with type 2 diabetes and diabetic foot ulcers in Catalonian primary care centers: a multicenter observational study. J Foot Ankle Res 2023; 16:8. [PMID: 36849888 PMCID: PMC9972716 DOI: 10.1186/s13047-023-00602-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 01/16/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Diabetic foot and lower limb complications are an important cause of morbidity and mortality among persons with diabetes mellitus. Very few studies have been carried out in the primary care settings. The main objective was to assess the prognosis of diabetic foot ulcer (DFU) in patients from primary care centers in Catalonia, Spain, during a 12-month follow-up period. METHODS We included participants with type 2 diabetes and a new DFU between February 2018 and July 2019. We estimated the incidence of mortality, amputations, recurrence and healing of DFU during the follow-up period. A multivariable analysis was performed to assess the association of these outcomes and risk factors. RESULTS During the follow-up period, 9.7% of participants died, 12.1% required amputation, 29.2% had a DFU recurrence, and 73.8% healed. Having a caregiver, ischemia or infection were associated with higher mortality risk (hazard ratio [HR]:3.63, 95% confidence interval [CI]:1.05; 12.61, HR: 6.41, 95%CI: 2.25; 18.30, HR: 3.06, 95%CI: 1.05; 8.94, respectively). Diabetic retinopathy was an independent risk factor for amputation events (HR: 3.39, 95%CI: 1.37; 8.39). Increasing age decreased the risk for a DFU recurrence, while having a caregiver increased the risk for this event (HR: 0.97, 95%CI: 0.94; 0.99). The need for a caregiver and infection decreased the probability of DFU healing (HR: 0.57, 95%CI: 0.39; 0.83, HR: 0.64, 95%CI: 0.42; 0.98, respectively). High scores for PEDIS (≥7) or SINBAD (≥3) were associated with an increased risk for DFU recurrence and a lower probability of DFU healing, respectively. CONCLUSIONS We observed high morbidity among subjects with a new DFU in our primary healthcare facilities. Peripheral arterial disease, infection, and microvascular complications increased the risk of poor clinical outcomes among subjects with DFU.
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Affiliation(s)
- Magdalena Bundó
- grid.452479.9DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Health Care Center Ronda Prim, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord de Barcelona, Institut Català de La Salut, Mataró, Spain
| | - Bogdan Vlacho
- grid.452479.9DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Pharmacology Department, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain ,grid.413396.a0000 0004 1768 8905Institut de Recerca Hospital de La Santa Creu I Sant Pau, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Judit Llussà
- grid.22061.370000 0000 9127 6969Primary Health Care Centre Sant Roc, Gerència d’Àmbit d’Atenció Primària Metropolitana Nord de Barcelona, Institut Català de La Salut, Mataró, Spain Catalan Health Institute, Badalona, Spain
| | - Isabel Bobé
- grid.22061.370000 0000 9127 6969Primary Health Care Center La Mina, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Sant Adrià de Besòs, Spain
| | - Meritxell Aivar
- grid.22061.370000 0000 9127 6969Primary Health Care Centre Sants, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain
| | - Carmen Ciria
- grid.22061.370000 0000 9127 6969Primary Health Care Centre Ponts. Gerència d’Àmbit d’Atenció Primària Lleida, Institut Català de La Salut, Lleida, Spain
| | - Ana Martínez-Sánchez
- grid.22061.370000 0000 9127 6969Primary Health Care Centre El Carmel. Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain
| | - Jordi Real
- grid.452479.9DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain ,grid.410675.10000 0001 2325 3084Universitat Internacional de Catalunya, Epidemiologia I Salut Pública, Sant Cugat, Spain
| | - Manel Mata-Cases
- grid.452479.9DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Health Care Center La Mina, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Sant Adrià de Besòs, Spain
| | - Xavier Cos
- grid.452479.9DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Primary Health Care Center Sant Martí de Provençals, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain ,grid.22061.370000 0000 9127 6969Innovation office at Institut Català de La Salut, Barcelona, Spain
| | - Montserrat Dòria
- grid.413396.a0000 0004 1768 8905Department of Endocrinology & Nutrition, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Jordi Viade
- grid.411438.b0000 0004 1767 6330Department of Endocrinology & Nutrition, Hospital Germans Trias I Pujol, Badalona, Spain
| | - Josep Franch-Nadal
- DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain. .,CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain. .,Primary Health Care Center Raval Sud, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain.
| | - Dídac Mauricio
- DAP-Cat Group. Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 375, Entresuelo. 08025, Barcelona, Spain. .,Institut de Recerca Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. .,CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain. .,Department of Endocrinology & Nutrition, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain. .,Department of Medicine, University of Vic - Central University of Catalonia, Vic, Spain.
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Pereira MG, Pedras S, Louro A, Lopes A, Vilaça M. Stress reduction interventions for patients with chronic diabetic foot ulcers: a qualitative study into patients and caregivers' perceptions. J Foot Ankle Res 2023; 16:3. [PMID: 36747299 PMCID: PMC9901134 DOI: 10.1186/s13047-022-00592-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/24/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The present study aimed to assess the perceptions of patients with chronic diabetic foot ulcers (DFUs) and their family caregivers regarding the impact of two stress reduction interventions on DFU and psychological wellbeing. The intervention included progressive muscle relaxation and hypnosis sessions. METHODS This study used a qualitative exploratory design and included individual interviews with eight patients with chronic DFUs and six family caregivers, using a semi-structured interview guide. Transcript analysis employed thematic content analysis. RESULTS Four key themes common to patients and their caregivers were found: 1) perspectives regarding the intervention; 2) intervention effectiveness; 3) perceived importance of psychology in the DFU treatment; and 4) emotional consequences associated with DFUs. Although themes were common to both intervention groups, sub-themes from the last two themes differed for patients that received muscle relaxation versus those who received hypnosis. CONCLUSION Patients and caregivers reported perceived benefits from both interventions, regarding DFU healing and emotional wellbeing. Patients who received hypnosis and their caregivers also reported lasting effects. Participants suggested that psychological interventions such as stress reduction interventions could be included in the DFU standard treatment as an adjuvant to the clinical protocol for DFU treatment, preferably offered early on, when patients begin treatment at the diabetic foot consultation.
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Affiliation(s)
- M. Graça Pereira
- grid.10328.380000 0001 2159 175XPsychology Research Centre (CIPsi), University of Minho, Braga, Portugal ,grid.10328.380000 0001 2159 175XSchool of Psychology, Department of Applied Psychology, University of Minho, Campus de Gualtar, Braga, 4710-057 Portugal
| | - Susana Pedras
- grid.5808.50000 0001 1503 7226Angiology & Vascular Surgery Department, Centro Hospitalar Universitário Porto (CHUP), Porto, Portugal
| | - André Louro
- grid.10328.380000 0001 2159 175XHealth & Family Research Group, Psychology Research Centre (CIPsi), University of Minho, Braga, Portugal
| | - Alberto Lopes
- Portuguese Association of Clinical Hypnosis and Hypnoanalysis (APHCH), Porto, Portugal
| | - Margarida Vilaça
- grid.10328.380000 0001 2159 175XPsychology Research Centre (CIPsi), University of Minho, Braga, Portugal
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Liu H, Li Z, Che S, Feng Y, Guan L, Yang X, Zhao Y, Wang J, Zvyagin AV, Yang B, Lin Q. A smart hydrogel patch with high transparency, adhesiveness and hemostasis for all-round treatment and glucose monitoring of diabetic foot ulcers. J Mater Chem B 2022; 10:5804-5817. [PMID: 35866488 DOI: 10.1039/d2tb01048h] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The treatment and management of diabetic foot ulcers (DFUs) is a pretty intractable problem for clinical nursing. Urgently, the "Black Box" status of the healing process prevents surgeons from providing timely analysis for more effective diagnosis and therapy of the wound. Herein, we designed a transparent monitoring system to treat and manage the DFUs with blood oozing and hard-healing, which resolved the problem of blind management for the other conductive patches. This system was prepared from a conductive hydrogel patch with ultra-high transparence (up to 93.6%), adhesiveness and hemostasis, which is engineered by assembling in situ formed poly(tannic acid) (PTA)-doped polypyrrole (PPy) nanofibrils in the poly(acrylamide-acrylated adenine) (P(AM-Aa)) polymer networks. Significantly, the high transparent conductive hydrogel patch can monitor the wound-healing status visually and effectively promote the healing of DFUs by accelerating hemostasis, improving communication between cells, preventing wound infection, facilitating collagen deposition, and promoting angiogenesis. In addition, the versatile hydrogel patch could realize indirect blood glucose monitoring by detecting the glucose levels on wounds, and further sense the movements with different magnitudes of human body timely. This research may provide a novel strategy in the design of chronic wound dressings for monitoring and treating the wounds synergistically.
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Affiliation(s)
- Hou Liu
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Zuhao Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
| | - Songtian Che
- Department of Ocular Fundus Disease, The Second Hospital of Jilin University, Changchun 130022, P. R. China
| | - Yubin Feng
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Lin Guan
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Xinting Yang
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Yue Zhao
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Jincheng Wang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun 130041, P. R. China
| | - Andrei V Zvyagin
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, Macquarie University, and Institute of Biology and Biomedicine, Lobachevsky Nizhny Novgorod State University 603105, Sydney, NSW 2109, Australia, Nizhny Novgorod, Russia
| | - Bai Yang
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
| | - Quan Lin
- State Key Laboratory of Supramolecular Structure and Materials, College of Chemistry, Jilin University, Changchun, 130012, P. R. China.
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Suglo JN, Winkley K, Sturt J. Prevention and Management of Diabetes-Related Foot Ulcers through Informal Caregiver Involvement: A Systematic Review. J Diabetes Res 2022; 2022:9007813. [PMID: 35462785 PMCID: PMC9021995 DOI: 10.1155/2022/9007813] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/28/2022] [Accepted: 03/22/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The literature remains unclear whether involving informal caregivers in diabetes self-care could lead to improved diabetic foot outcomes for persons at risk and/or with foot ulcer. In this review, we synthesized evidence of the impact of interventions involving informal caregivers in the prevention and/or management of diabetes-related foot ulcers. METHODS A systematic review based on PRISMA, and Synthesis Without Meta-analysis (SWiM) guidelines was conducted. MEDLINE (Ovid), Embase (Ovid), PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trial of the Cochrane Library databases were searched from inception to February 2021. The following MESH terms were used: diabetic foot, foot ulcer, foot disease, diabetes mellitus, caregiver, family caregiver ,and family. Experimental studies involving persons with diabetes, with or at risk of foot ulcers and their caregivers were included. Data were extracted from included studies and narrative synthesis of findings undertaken. RESULTS Following the search of databases, 9275 articles were screened and 10 met the inclusion criteria. Studies were RCTs (n = 5), non-RCTs (n = 1), and prepoststudies (n = 4). Informal caregivers through the intervention programmes were engaged in diverse roles that resulted in improved foot ulcer prevention and/or management outcomes such as improved foot care behaviors, increased diabetes knowledge, decreased HbA1c (mmol/mol or %), improved wound healing, and decreased limb amputations rates. Engaging both caregivers and the person with diabetes in education and hands-on skills training on wound care and foot checks were distinctive characteristics of interventions that consistently produced improved foot self-care behavior and clinically significant improvement in wound healing. CONCLUSION Informal caregivers play diverse and significant roles that seem to strengthen interventions and resulted in improved diabetes-related foot ulcer prevention and/or management outcomes. However, there are multiple intervention types and delivery strategies, and these may need to be considered by researchers and practitioners when planning programs for diabetes-related foot ulcers.
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Affiliation(s)
- Joseph Ngmenesegre Suglo
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, UK
- Department of Nursing, Presbyterian University College Ghana, Ghana
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, UK
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, UK
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Lima LJLD, Lopes MR, Botelho Filho CADL, Cecon RS. Avaliação do autocuidado com os pés entre pacientes portadores de diabetes melito. J Vasc Bras 2022; 21:e20210011. [PMID: 35251141 PMCID: PMC8862594 DOI: 10.1590/1677-5449.210011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. Objectives To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. Methods This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). Results 58% of the sample did not know the term “diabetic foot”, but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. Conclusions Interviewed patients with DM did not perform all foot self-care activities and did not know what the term “diabetic foot” means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.
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Nguyen TD, Bygbjerg IC, Meyrowitsch DW, Gammeltoft T, Le CD, Nguyen AT, Søndergaard J. Perceived knowledge on type-2 diabetes of informal caregivers in rural communities of Thai Binh, Vietnam: Implications for health education. PUBLIC HEALTH IN PRACTICE 2021; 2:100210. [PMID: 36101603 PMCID: PMC9461477 DOI: 10.1016/j.puhip.2021.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/14/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives Informal caregivers' (ICGs') knowledge has substantial influence on the quality of caregiving. This study aims to identify caregivers’ perceived knowledge status and analyse associations between their characteristics and perceived knowledge on how to care for individuals with type-2 diabetes (T2D). Study design Cross-sectional study. Methods Data were collected using a face-to-face survey with ICGs and perceived knowledge was evaluated on the 5-point Likert scale (ranging from 0 to 4). Results Between April and July 2019, 1238 eligible ICGs were enrolled in the study. The mean age of participants was 48.3 years, about half (48.8%) were males and the majority (83.3%) were spouses or children of the person they cared for. ICGs mean knowledge score on overall activities was 2.48 (SD = 0.90); the highest score was seen for diet preparation (2.74 ± 0.85) and lowest for foot care (1.76 ± 1.45). Multivariate analyses showed that the following ICG characteristics were significantly more likely to result in a low level of T2D-related knowledge (mean score ≤2): age <40 years, educational level below high school, farming occupation, low economic status and caring for an individual with mild or moderate T2D. Conclusions The level of perceived knowledge on T2D among ICGs was particularly low for the care of T2D complications. Development of targeted and tailored educational interventions for ICGs is recommended.
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Trajectory of Psychosocial Measures amongst Informal Caregivers: Case-Controlled Study of 1375 Informal Caregivers from the English Longitudinal Study of Ageing. Geriatrics (Basel) 2020; 5:geriatrics5020026. [PMID: 32349243 PMCID: PMC7345989 DOI: 10.3390/geriatrics5020026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/17/2022] Open
Abstract
Informal caregivers provide vital support for older adults living in the community with chronic illnesses. The purpose of this study was to assess the psychosocial status of informal caregivers of community-dwelling adults over an eight-year period. Informal caregivers of adult care-recipients were identified from Wave 1 of the English Longitudinal Study of Ageing (ELSA) cohort. Multivariate regression analysis models were constructed to assess the association between participant's psychosocial characteristics and informal caregiving. Multilevel modelling explored the psychosocial changes between caregivers and non-caregivers over eight years. 1375 informal caregivers and 2750 age-matched non-caregivers were analyzed. Self-reported loneliness (Odd Ratio (OR): 0.26; 95% confidence intervals (CI): 0.01-0.51) and relationship status (OR: 0.36; 95% CI: 0.16-0.46) were independently associated with caregiving. Caregivers were more socially isolated with less holidaying abroad (OR: 0.51; 95% CI: 0.35-0.66), attendance to church (OR: 0.30; 95% CI: 0.11-0.49), or charity groups (OR: 0.35; 95% CI: 0.14-0.55). On multilevel analysis, over time (eight-years), caregivers reported greater loneliness (p < 0.01), change in relationship status (p = 0.01) and reduced control, autonomy, and pleasure (p ≤ 0.01) compared to non-caregivers. Given the deleterious effects caregiving can place on health and wellbeing, further interventions are required to improve these psychosocial factors.
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