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Lopes GSG, Landeiro MJL, Maciel T, Sousa MRMGCD. Clinical practice guidelines of foot care practice for patients with type 2 diabetes: A scoping review using self-care model. Contemp Nurse 2024:1-21. [PMID: 38831701 DOI: 10.1080/10376178.2024.2362289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Type 2 diabetes can lead to severe foot complications, making self-care education, guided by clinical guidelines, crucial. However, fragmented and dispersed recommendations challenge effective implementation of these guidelines. Bringing together recommendations and presenting them according to a self-care model can provide a solid framework and facilitate the interpretation of results. AIMS to map the international guidelines that provide recommendations to nurses to enable people with type 2 diabetes for foot self-care and synthesize the recommendations according to the key concepts of the middle-range theory of self-care for chronic diseases. DESIGN A scoping review was undertaken, using the methodological guidance of the Joanna Briggs Institute. DATA SOURCES Databases were searched between September 2022 and June 2023, including PubMed, CINAHL, PsycINFO, Scopus, Web of Science Core Collection, ProQuest Dissertations and Theses Global, guideline websites and related professional association websites. The databases were chosen for their comprehensive coverage of the area. METHODS Eligible articles included guidance documents providing foot care recommendations for diabetes, published or updated between 2013 and 2023. Two reviewers summarized the recommendations presented in at least two guidelines according to the key concepts of the self-care model. The PRISMA-ScR checklist was used. RESULTS Seventeen guidelines were included. In total, we synthesized 175 recommendations. The recommendations were framed in three dimensions and their respective categories: Self-care maintenance (education for prevention, control of risk factors, daily foot care, footwear, and socks), Self-care monitoring (foot inspection, detection of signs of infection, and detection of other diabetes-related foot disease complications), and Self-care management (responses to signs and symptoms, foot wound care, follow-up with health professionals, and health services). CONCLUSIONS The main aspect of foot care revolves around daily care, including cleaning, moisturizing, nail care, selecting appropriate footwear, and regular inspection of both feet and footwear.
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Affiliation(s)
- Geysa Santos Góis Lopes
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- CINTESIS@RISE NursID, Porto, Portugal
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Nekouei M, Tehrani FJ, Vasli P, Nasiri M. 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. NURSE EDUCATION TODAY 2024; 137:106164. [PMID: 38503249 DOI: 10.1016/j.nedt.2024.106164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
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.
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Affiliation(s)
- Mehrad Nekouei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereshteh Javaheri Tehrani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Drovandi A, Seng L, Golledge J. Effectiveness of educational interventions for diabetes-related foot disease: A systematic review and meta-analysis. Diabetes Metab Res Rev 2024; 40:e3746. [PMID: 37926437 DOI: 10.1002/dmrr.3746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
This systematic review and meta-analysis pooled evidence from randomised controlled trials (RCTs) on the effectiveness of educational programs for people with or at risk of diabetes-related foot disease (DFD). A systematic search identified RCTs evaluating the effectiveness of educational programs in preventing or managing DFD. The primary outcome was risk of developing a foot ulcer. Secondary outcomes included any amputation, mortality, changes in cardiovascular risk factors, foot-care knowledge and self-care behaviours. Meta-analyses were performed using random effects models. Risk of bias was assessed using Cochrane's ROB-2 tool. Education programs were tested in 29 RCTs (n = 3891) and reduced risk of a foot ulcer by approximately half although the upper 95% confidence interval (CI) reached 1.00 (odds ratio [OR], OR 0.54; 95% CI 0.29, 1.00, I2 = 65%). Education programs reduced risk of any amputation (OR 0.34; 95% CI 0.13, 0.88, I2 = 38%) and HbA1c levels (standardized mean difference -0.73; 95% CI -1.26, -0.20, I2 = 93%) without affecting all-cause mortality (OR 1.09; 95% CI 0.57, 2.07, I2 = 0%). Education programs mostly significantly improved DFD knowledge (13 of 16 trials) and self-care behaviour scores (19 of 20 trials). Only one trial was deemed at low risk of bias. Previously tested education programs have mostly effectively improved participants' knowledge and self-care behaviours and reduced risk of foot ulceration and amputation. Larger high quality trials with longer follow-up are needed.
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Affiliation(s)
- Aaron Drovandi
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Leonard Seng
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
- The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
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Kanan P, Siribumrungwong B, Tharavanij T, Orrapin S, Napunnaphat P. The needs of patients with diabetes for the prevention and treatment of foot complications in Thailand: A qualitative descriptive study. BELITUNG NURSING JOURNAL 2023; 9:586-594. [PMID: 38130669 PMCID: PMC10731426 DOI: 10.33546/bnj.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/21/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
Background Inadequate diabetes self-management leads to foot infections and lower extremity amputations. Effective self-care, supported by nurse-provided information, is crucial, particularly in foot care. However, the current approach in Thailand focuses more on what nurses want patients to know rather than addressing patients' actual needs. Consequently, nurses might misunderstand their patients' perspectives. Hence, nurses need to grasp patients' needs for successful foot care behavior. Objective This study aimed to explore the needs of patients with diabetes regarding the prevention and treatment of foot complications. Methods The study employed a qualitative descriptive design. Thirty participants classified as high risk for foot ulcers were purposively selected from Thailand's university hospitals. Focus group discussions were used for data collection between June and July 2021. Verbatim transcription and content analysis were carried out for data analysis. Results Four emergent themes highlighted patients' needs: 1) information-giving, 2) proactive foot screening with foot-care affirmation, 3) foot care services, and 4) relieving foot burdens and limb loss. Conclusion Nurses should change their mindset to care for and continually understand patients' needs. This involves adapting educational strategies like the teach-back method and coaching while providing skill training. Offering diverse service platforms, both online and onsite education programs and counseling, is essential. Additionally, ensuring accessibility and affordability, such as establishing after-hours clinics and supplying foot care toolkits, remains crucial.
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Affiliation(s)
- Piyawan Kanan
- Faculty of Nursing, Thammasat University, Pathum Thani, Thailand
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Wang H, Luo W, Ye Y, Li N, Li X, Fu X, Yu L, Hu T, Dai W, Zhou Q. Knowledge, attitudes, and practice of Endocrinology healthcare workers regarding screening for pre-ulcerative diabetic foot lesions. J Tissue Viability 2023; 32:472-479. [PMID: 37558559 DOI: 10.1016/j.jtv.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To investigate knowledge, attitude and practice of screening pre-ulcerative lesions among endocrinology healthcare workers. METHODS A new questionnaire was developed and distributed online and 1004 valid questionnaires were returned. T-test, ANOVA, Pearson correlation analysis, and multiple linear regression were used for statistical analysis. RESULTS A total of 1100 questionnaires were returned, and 96 were excluded. The scores of endocrinology healthcare workers' knowledge, attitude, and practice for screening for pre-ulcerative lesions were 45.46 ± 16.26, 92.11 ± 10.50, and 72.27 ± 17.63 respectively. 60.2% participants had been trained to screen for pre-ulcerative lesions, but 39.8% had not been trained. 31.8% of healthcare professionals claimed that their hospital did not have a screening project for pre-ulcer diabetic foot lesions. Positive relationships were found between knowledge and practice and between attitude and practice. Multiple linear regression analysis showed that: level II hospital and tertiary hospital were the main factors influencing the knowledge scores; Undergraduate and participating in relevant training were the main factors influencing the attitude scores; participating in relevant training, hospital conducts relevant projects, and patient cooperation, and working hours were the main factors influencing the practice score. CONCLUSIONS Endocrinology healthcare workers need more knowledge regarding pre-ulcerative lesions, and their screening practices need to be strengthened. Increased education and training for pre-ulcerative lesion screening should be implemented among healthcare workers in endocrinology departments.
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Affiliation(s)
- Honglin Wang
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Wenjing Luo
- Abdominal Oncology Ward, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Ying Ye
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Na Li
- Xiangya Nursing School of Central South University, Changsha, 410013, China
| | - Xinyi Li
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Operating Room, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Xiaoai Fu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ling Yu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ting Hu
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Weiwei Dai
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Wound Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Qiuhong Zhou
- Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, 410008, China; Diabetic Foot Prevention and Treatment Center, Xiangya Hospital, Central South University, Changsha, 410008, China.
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Mousa KM, Mousa FA, Mohamed HS, Elsawy MM. Prediction of Foot Ulcers Using Artificial Intelligence for Diabetic Patients at Cairo University Hospital, Egypt. SAGE Open Nurs 2023; 9:23779608231185873. [PMID: 37435577 PMCID: PMC10331222 DOI: 10.1177/23779608231185873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/10/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction In Egypt, diabetic foot ulcers markedly contribute to the morbidity and mortality of diabetic patients. Accurately predicting the risk of diabetic foot ulcers could dramatically reduce the enormous burden of amputation. Objective The aim of this study is to design an artificial intelligence-based artificial neural network and decision tree algorithms for the prediction of diabetic foot ulcers. Methods A case-control study design was utilized to fulfill the aim of this study. The study was conducted at the National Institute of Diabetes and Endocrine Glands, Cairo University Hospital, Egypt. A purposive sample of 200 patients was included. The tool developed and used by the researchers was a structured interview questionnaire including three parts: Part I: demographic characteristics; Part II: medical data; and Part III: in vivo measurements. Artificial intelligence methods were used to achieve the aim of this study. Results The researchers used 19 significant attributes based on medical history and foot images that affect diabetic foot ulcers and then proposed two classifiers to predict the foot ulcer: a feedforward neural network and a decision tree. Finally, the researchers compared the results between the two classifiers, and the experimental results showed that the proposed artificial neural network outperformed a decision tree, achieving an accuracy of 97% in the automated prediction of diabetic foot ulcers. Conclusion Artificial intelligence methods can be used to predict diabetic foot ulcers with high accuracy. The proposed technique utilizes two methods to predict the foot ulcer; after evaluating the two methods, the artificial neural network showed a higher improvement in performance than the decision tree algorithm. It is recommended that diabetic outpatient clinics develop health education and follow-up programs to prevent complications from diabetes.
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Affiliation(s)
- Khadraa Mohamed Mousa
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Farid Ali Mousa
- Information Technology Department, Faculty of Computers and Artificial Intelligence, Beni-Suef University, Beni-Suef, Egypt
| | - Helalia Shalabi Mohamed
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
- Community Health Nursing, College of Nursing, PAAET, Safat, Kuwait
| | - Manal Mohamed Elsawy
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
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Korada HY, Arora E, Maiya GA, Rao S, Hande M, Shetty S, Gundmi S, Anche P, Amravadi S. Effectiveness of Photobiomodulation Therapy on Neuropathic Pain, Nerve Conduction and Plantar Pressure Distribution in Diabetic Peripheral Neuropathy - A Systematic Review. Curr Diabetes Rev 2023; 19:e290422204244. [PMID: 37622461 DOI: 10.2174/1573399818666220429085256] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/19/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetic peripheral neuropathy is a severe complication of type 2 diabetes mellitus. The most common symptoms are neuropathic pain and altered sensorium due to damage to small nerve fibers. Altered plantar pressure distribution is also a major risk factor in diabetic peripheral neuropathy, leading to diabetic foot ulcers. OBJECTIVE The objective of this systematic review was to analyze the various studies involving photobiomodulation therapy on neuropathic pain and plantar pressure distribution in diabetic peripheral neuropathy. METHODS We conducted a systematic review (PubMed, Web of Science, CINAHL, and Cochrane) to summarise the evidence on photobiomodulation therapy for Diabetic Peripheral Neuropathy with type 2 diabetes mellitus. Randomized and non-randomized studies were included in the review. RESULTS This systematic review included eight studies in which photobiomodulation therapy showed improvement in neuropathic pain and nerve conduction velocity. It also reduces plantar pressure distribution, which is a high risk for developing foot ulcers. CONCLUSION We conclude that photobiomodulation therapy is an effective, non-invasive, and costefficient means to improve neuropathic pain and altered plantar pressure distribution in diabetic peripheral neuropathy.
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Affiliation(s)
- Hrishikesh Yadav Korada
- Centre for Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Esha Arora
- Centre for Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
- Faculty of Allied Health Professions, AIMST University, Bedong, 08100, Malaysia
| | - Gundmi Arun Maiya
- Centre for Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Sharath Rao
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Manjunath Hande
- Comprehensive Geriatric Clinic, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Sahana Shetty
- Department of Endocrinology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Shubha Gundmi
- Centre for Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Parameshwar Anche
- Centre for Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India
| | - Sampath Amravadi
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, UAE
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Ranuve MS, Mohammadnezhad M. Healthcare workers' perceptions on diabetic foot ulcers (DFU) and foot care in Fiji: a qualitative study. BMJ Open 2022; 12:e060896. [PMID: 35918113 PMCID: PMC9351318 DOI: 10.1136/bmjopen-2022-060896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the perception of healthcare workers (HCWs) on diabetic foot ulcers (DFU) and foot care in Rotuma, Fiji. DESIGN Using a qualitative study design, two focus group discussions (FGDs) were conducted among HCWs. A semistructured open-ended questionnaire was used to guide the discussion session. Each FGD was audiorecorded and was transcribed. The transcriptions were then manually analysed using thematic analysis. SETTING Rotuma hospital, Fiji. PARTICIPANTS HCWs who were working in Rotuma hospital for at least a year and were involved in clinical foot care of type 2 diabetes mellitus patients were included. RESULTS There were five main themes, namely, depth of knowledge, quality of care in practice, factors of influence on practice, lack of resources and capacity building. Participants had superficial knowledge that showed lack of in-depth scientific knowledge. A lack of staffing in the clinics affected the delivery of service. Additionally, patients defaulting clinics, late presentations with DFU and traditional medicine also affected the quality of healthcare service in clinics. There was also a need for a multidisciplinary team to prevent and manage DFU. HCWs mostly advised on glycaemic control and ignored offering foot care advice in clinics due mainly to the lack of sound knowledge on foot care. There was also a lack of resources, infrastructure, space and professional development opportunities, which negatively impacted how HCWs deliver foot care services to patients. CONCLUSION HCWs lack significant in-depth knowledge on DFU and foot care. In addition, these are the availability of traditional medicine that delays presentations to hospital, further reducing the quality of services. HCWs need to keep their knowledge and skills updated through regular in-service training on foot care. Resources, infrastructure and supply chains need to be maintained by those in power to ensure HCWs deliver quality foot care services.
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Affiliation(s)
| | - Masoud Mohammadnezhad
- Faculty of Health Studies, School of Nursing and Healthcare Leadership, University of Bradford, Bradford, UK
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Mateti U, Raju B, Mohan R, Shastry CS, Joel J, D’Souza N, Mariam A. Educational Interventions and Its Impact on the Treatment Outcomes of Diabetic Foot Ulcer Patients. JOURNAL OF DIABETOLOGY 2022. [DOI: 10.4103/jod.jod_99_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158021. [PMID: 34360314 PMCID: PMC8345419 DOI: 10.3390/ijerph18158021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022]
Abstract
Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants’ knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.
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Abate TW, Enyew A, Gebrie F, Bayuh H. Nurses' knowledge and attitude towards diabetes foot care in Bahir Dar, North West Ethiopia. Heliyon 2020; 6:e05552. [PMID: 33294694 PMCID: PMC7695951 DOI: 10.1016/j.heliyon.2020.e05552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/09/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
A diabetes foot ulcer is the commonest non-traumatic reason for the amputation of the lower extremities. All adults with diabetes should undergo comprehensive foot evaluation at least annually, but for high-risk individuals with diabetes more frequently by a health care provider and daily by the people themselves. Nurses' knowledge and attitude are fundamental to conduct a diabetes foot risk assessment and provide foot care for known diabetes person. Knowledge and attitude of nurses about the assessment and risk, identification of diabetes foot are not well studied in Ethiopia, especially in the study area. Therefore, this study aimed to assess nurses' knowledge and attitude towards diabetes foot ulcer in Bahir Dar, North West Ethiopia. An institution-based cross-sectional study was conducted in Bahir Dar city administration hospitals from January 1st to 5th, 2019. The study participants were selected using a simple random sampling technique. Nurses' level of knowledge and attitude towards diabetes foot ulcer assessment and management determined by using multiple-choice questions of nurse's knowledge and attitude questionnaires. The association between the independent and dependent variables was assessed. In this study, the overall proportions of nurses' knowledge and attitude towards diabetes foot assessment and management were 54.4% and 43.3% respectively. Age less than 30 years old (AOR = 2.15, 95%CI: 1.10, 4.19; P = 0.025), the nurse who graduates from a governmental institution (AOR = 3.05, 95% CI: 1.64, 5.69; P < 0.001) and use the internet as a source of knowledge (AOR = 0.55, 95%CI: 0.31, 0.96; P = 0.035) was significantly associated with nurses' knowledge towards diabetes foot care. Age less than 30 years old (AOR = 1.98, 95% CI: 1.16, 3.35; P = 0.012)and the nurse level of qualification (AOR = 0.39, 95% CI: 0.20, 0.78; P = 0.007)were significantly associated with nurses' level of attitude towards diabetes foot care. In conclusion, this study demonstrated the important gaps in nurses' knowledge and attitude towards diabetes foot care. Nurses' insufficient knowledge and non-favorable attitude towards diabetes foot care compromise health care standard diabetes care. Therefore, a comprehensive revision of nursing curricula across local tertiary learning institutes required qualified instructors and a strengthened regulatory body (especially private ones), and validated source of information for allowing nurses to update their knowledge is warranted.
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Affiliation(s)
- Teshager Woldegiorgis Abate
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Alamirew Enyew
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Feleke Gebrie
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Haregnesh Bayuh
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
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Abdulwassi HK, Safhi MA, Hashim RT, Fallatah AM, Hussein SS, Almusallam SA, Alsaad MS, Alkhatieb MT. Knowledge of diabetic foot care management among medical students at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Saudi Med J 2020; 41:59-67. [PMID: 31915796 PMCID: PMC7001075 DOI: 10.15537/smj.2020.1.24812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To evaluate medical students' knowledge of diabetic foot care management and its related factors. METHODS This was a cross-sectional, descriptive study of 303 students studying at King Abdulaziz University Hospital, Jeddah, Saudi Arabia conducted from June to July 2019. Data were collected using a two-part questionnaire. The first one captured student information; the second assessed student knowledge. It consists of 68 true and false questions divided into 4 subscales (risk factors, foot examination, foot complications and footwear selection). The higher the total score is, the higher the students' knowledge. RESULTS The total average knowledge score was 55.5±5.5 out of 68. While the mean score was 14.11/16 for risk factors, 9.24/10 for foot examination, 24.21/32 for foot complications, and 7.88/10 for footwear selection subscales. Only 56.4% of students educated diabetic patients about diabetic foot risks;concurrently, only 63% performed foot examinations in diabetes patients. Students who educated diabetic patients, preformed foot exam, or attended extra elective clinical rotation in a diabetic foot team, had a significantly higher knowledge level. Conclusion: Students were found to have high level of knowledge regarding diabetic foot management. Students who educated patients about diabetic foot risk, performed foot examination on patients and students who took elective rotations in a diabetic foot care team had a higher knowledge level.
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Affiliation(s)
- Hassan K Abdulwassi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
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13
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Fujii K, Stolt M. Evaluation of the development process and effects of a foot care program with educational tools for nurses and care workers as in-home service providers. BMC Res Notes 2020; 13:418. [PMID: 32891178 PMCID: PMC7487692 DOI: 10.1186/s13104-020-05263-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/29/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Nurses and care workers who provide in-home services play important roles in assessing and providing care for older people who lack foot self-care abilities. We aimed to evaluate the development process and effects of a foot care program with educational tools for nurses and care workers as in-home service providers. This is a process evaluation with a descriptive mixed-methods study of quantitative and qualitative data conducted from July to October 2019 in Japan. Results Foot care education tools were developed to address the issues faced by participants with various work patterns and insufficient foot care education in Japan. The contents of these tools were discussed by a panel and reviewed by experts. Three outcomes were analyzed using descriptive statistics and Pearson’s correlation. Changes in foot care practice scores were significantly correlated with performance scores. The evaluations of five of the eight field nurses suggested that excess information was included in the foot care booklet. Overall, 29 nurses and care workers showed higher than average evaluation scores [3.8–4.1 (standard deviation, 0.62–0.91)] for the motion pictures and PowerPoint presentation. A program according to this conceptual framework must be established and periodically evaluated for refinement. Trial Registration The trial registration number for the University Hospital Medical Information Network is UMIN000036307. Registration Date—2019/07/25
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Affiliation(s)
- Kashiko Fujii
- Graduate School of Medicine, School of Health Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higasi-ku, Nagoya, Aichi, Japan.
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
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14
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Fujii K, Komoda T, Maekawa A, Nishikawa M. Foot care knowledge and practices among Japanese nurses and care workers in home care and adult service center: a cross- sectional study. BMC Nurs 2020; 19:75. [PMID: 32782433 PMCID: PMC7412637 DOI: 10.1186/s12912-020-00467-1] [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: 04/08/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background Foot care knowledge and practices among nurses and care workers in the community greatly impact foot health maintenance and prevention of foot-related problems among older people. This study aimed to explore and examine the current foot care knowledge, practices, and perceptions among nurses and care workers at home care and adult day service center, along with their demographic characteristics and daily care for clients. Methods This study analyzed 232 randomly selected front-line nurses and care workers working at home care or adult day service center in one of the selected cities, Aichi Prefecture, Japan. Data were obtained using questionnaires and subsequently analyzed using descriptive statistics, t-tests, Chi-square tests, Wilcoxon rank-sum tests, and Spearman's rank correlation tests. Results Among the 305 surveyed, 232 (62 nurses; 170 care workers) provided data. Although 57 nurses (91.9%) and 142 care workers (83.5%) showed interest in foot care, 33 nurses (53.2%) and 133 care workers (78.2%) stated that foot care education was insufficient. Knowledge and practice scores were associated with working status.Higher accuracy differences in the early detection of foot problems and skin tears on lower limbs in knowledge category were observed between nurses and care workers. The nurses as well as the care workers had low accuracy rates of knowledge questions regarding the use of shoes and socks subscale.For practice, both nurses and care workers had low mean scores for checking client's shoes (2.0/5.0 and 2.1/5.0, respectively), method for reducing ingrown nail pain (2.6/5.0 and 1.9/5.0, respectively), and opportunity for discussing foot care with others (2.7/5.0 and 2.2/5.0, respectively). A significant correlation between knowledge and practice scores was observed among nurses (0.331, p < 0.05) and care workers (0.339, p < 0.001). Conclusions Despite the presence of several barriers toward enhanced care delivery to clients needing it most, nurses and care workers clearly understood the importance of foot care. These findings indicate that foot care should be focused by nurses and care workers to improve the knowledge and practice of foot care and to suggest future implications that efficient and understandable tools are needed considering their current working situation.
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Affiliation(s)
- Kashiko Fujii
- Graduate School of Medicine, School of Health Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya City, Aichi Prefecture 461-8673 Japan
| | - Takuyuki Komoda
- Department of Plastic and Reconstructive Surgery, Gifu Heart Center, 4-14-4 Yabuta Minami, Gifu City, Gifu Prefecture 500-8384 Japan
| | - Atsuko Maekawa
- Faculty of Nursing, Shubun University, 6 Nikko-cho, Ichinomiya-City, Aichi Prefecture 491-0938 Japan
| | - Mariko Nishikawa
- Graduate School of Nursing, University of Human Environments, 3-220 Ebata-Cho, Obu City, Aichi Prefecture 4740035 Japan
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Fujii K, Stolt M. Intervention study of a foot-care programme enhancing knowledge and practice among nurses and care workers at in-home service providers. Nurs Open 2020; 7:1039-1051. [PMID: 32587723 PMCID: PMC7308698 DOI: 10.1002/nop2.479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022] Open
Abstract
Aim To evaluate the foot-care educational programme for nurses and care workers at in-home service providers. Design A non-randomized controlled study with random cluster sampling method. Methods Study participants were nurses and care workers of 21 in-home service providers, including home-visit nursing and care providers, 1-day care service centres or care centres with rehabilitation programme in Japan. Foot-care programme with foot-care tools as a package or standard care comprising 3-5 sessions over 2 months was provided to 110 participants (87 were on analysis). The outcomes were changes in foot-care knowledge and scores in pre-post interventions. Data were analysed with descriptive statistics, t test, logistic regression analysis and ANCOVA. Results Before adjusting for background, total scores of knowledge and practice categories were higher than the baseline in the intervention group (43 participants) compared with the control group (44 participants). After background correction due to potential bias of non-random cluster sampling, significant between group differences were observed in mean score changes in skin and consultation subscales of the practice category.
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Affiliation(s)
- Kashiko Fujii
- Graduate School of MedicineSchool of Health SciencesNagoya UniversityNagoya CityJapan
- University of Human EnvironmentsObuJapan
| | - Minna Stolt
- Department of Nursing ScienceUniversity of TurkuTurkuFinland
- Turku University HospitalTurkuFinland
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Re: Differences Between Patient-Reported Versus Clinician-Observed Nonulcerative Signs and Symptoms of the Foot in Patients With Diabetes Mellitus. J Wound Ostomy Continence Nurs. 2019;46(2):113-116. J Wound Ostomy Continence Nurs 2019; 46:282. [DOI: 10.1097/won.0000000000000552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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