Diabetic foot workshop: A strategy for improving the knowledge of diabetic foot care providers

Comprehensive nursing model for diabetic foot ulcers: A strategy to improve prognosis and quality of life

Diabetic foot (DF) ulcer is one of the common complications of diabetic patients, with high incidence and amputation rate, which seriously affects the quality of life and health of patients. Therefore, how to effectively prevent and treat DF ulcers and reduce amputation rate has become an urgent problem in the medical field. As a comprehensive nursing model for patients with DF ulcers, comprehensive nursing intervention is designed to improve the therapeutic effect and prognosis and reduce the rate of amputation. Convenient sampling method was used to select 360 patients with DF who received routine care for DF ulcers from July 2013 to July 2023 for retrospective cohort analysis. According to the existence of exposure factors (comprehensive nursing intervention), 180 cases were divided into observation group and comparison group. The basic demographic data, amputation rate, severity of foot ulcer, neuropathy and vascular disease, and blood glucose control were compared between the 2 groups. The data was analyzed using SPSS26.0. Harman single factor test was used to check whether there was common method bias in the study data. Descriptive analysis, Spearman rank correlation analysis and multiple linear regression analysis were used to analyze the current situation of amputation rate of DF patients and the influence of comprehensive nursing intervention on the amputation rate of DF patients. The amputation rate was 2.8% in the Observation group compared to 8.3% in the Comparison group. The amputation rate of the observation group was generally higher in the age group, and the amputation rate of the observation group was higher in the middle school education level and below and the economic status of <5000 yuan. The difference was statistically significant (P < .05). Age (odds ratio [OR] = 1.96; 95% confidence interval [CI]: 0.88-4.38), education level (OR = 1.30; 95% CI: 1.69-6.46), economic status (OR = 2.28; 95% CI: 1.69-10.85) was an independent risk factor for amputation rate (P < .05). Comprehensive nursing interventions have played a positive role in reducing the rate of amputation in patients with DF.

The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial

BACKGROUND

Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients.

OBJECTIVES

To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students.

DESIGN

A single-blind, randomized controlled trial with a parallel group.

SETTINGS

This study was conducted in a nursing school and hospitals covered by it in Iran.

PARTICIPANTS

98 students studying in the fourth semester of the Bachelor of Nursing course.

METHODS

Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests.

RESULTS

The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion.

CONCLUSIONS

Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.

Foot Care Prioritization Among Health Care Providers Treating Diabetic Patients in Saudi Arabia: A Survey-Based Study

BACKGROUND

Diabetic foot disease (DFD) is a significant complication associated with diabetes, characterized by the potential for progressive amputation of specific foot segments or the entire lower limb in the absence of timely identification of infection and intervention. The aim of our research is to evaluate the degree of importance given to foot care by healthcare professionals who are responsible for treating individuals with diabetes in Riyadh, Saudi Arabia.

METHODS

This cross-sectional study utilized an online survey previously validated in Australia. The mean foot care prioritization score was used to identify the dummy variable for binary logistic regression analysis, which was used to identify predictors of foot care prioritization.

RESULTS

A total of 222 participants were involved in this study. Assessing for the risk of developing foot complications, visually inspecting feet for wounds, and providing or recommending footwear to prevent foot complications were the most commonly reported practices, accounting for 80.60% (n = 178), 76.10% (n = 169), and 75.20% (n = 167), respectively. The most commonly referred patients to a specialist tertiary multi-disciplinary foot care team were patients with ulcers in patients with absent foot pulses, ulcers with ascending cellulitis, and diabetic ulceration, accounting for 73.50% (n = 163), 71.60% (n = 159), and 66.70% (n = 148), respectively. The mean foot care prioritization score for the study participants was 54.1 (standard deviation: 11.7) out of 78 (69.4%), which demonstrates a moderately high level of foot care prioritization. Binary logistic regression analysis identified that healthcare professionals who are aged 35-44 years, those who have 5-10 years of experience, those who work at private hospitals, those who have a higher number of practice clinics per week, and those who have to manage a higher number of patients with diabetes in each clinic were more likely to prioritize foot care in their practices (p < 0.05).

CONCLUSION

Our study found that healthcare professionals in Saudi Arabia place a moderate degree of emphasis on foot care. Healthcare professionals falling within the age range of 35-44 years, possessing 5-10 years of experience, employed at private hospitals, overseeing a greater number of practice clinics weekly, and managing a greater number of patients with diabetes per clinic exhibited a greater propensity to prioritize foot care within their respective practices. Policymakers should consider the integration of continuous glucose monitoring technologies, the establishment of standardized foot screening protocols, and the implementation of targeted educational programs for healthcare professionals.

Physicochemical Evaluation of L-Ascorbic Acid and Aloe vera-Containing Polymer Materials Designed as Dressings for Diabetic Foot Ulcers

Hydrogels belong to the group of polymers that are more and more often considered as innovative dressing materials. It is important to develop materials showing the most advantageous properties from the application viewpoint wherein in the case of hydrogels, the type and the amount of the crosslinking agent strongly affect their properties. In this work, PVP-based hydrogels containing Aloe vera juice and L-ascorbic acid were obtained via UV-induced polymerization. Next, their surface morphology (via both optical, digital and scanning electron microscope), sorption capacity, tensile strength, and elongation were characterized. Their structure was analyzed via FT-IR spectroscopy wherein their impact on the simulated body liquids was verified via regular pH and temperature measurements of these liquids during hydrogels' incubation. It was demonstrated that as the amount of the crosslinker increased, the polymer structure was more wrinkled. Next, hydrogels showed relatively smooth and only slightly rough surface, which was probably due to the fact that the modifiers filled also the outer pores of the materials. Hydrogels demonstrated buffering properties in all incubation media, wherein during the incubation the release of Aloe vera juice probably took place as evidenced by the decrease in the pH of the incubation media and the disappearance of the absorption band deriving from the polysaccharides included in the composition of this additive. Next, it was proved that as the amount of the crosslinker increased, hydrogels' crosslinking density increased and thus their swelling ratio decreased. Hydrogels obtained using a crosslinking agent with higher average molecular weight showed higher swelling ability than the materials synthesized using crosslinker with lower average molecular weight. Moreover, as the amount of the crosslinking agent increased, the tensile strength of hydrogels as well as their percentage elongation also increased.