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Ruiz-Muñoz M, Fernández-Torres R, Formosa C, Gatt A, Pérez-Panero AJ, Pérez-Belloso AJ, Martínez-Barrios FJ, González-Sánchez M. Development and validation of a new questionnaire for the assessment of patients with diabetic foot disease: The Diabetic Foot Questionnaire (DiaFootQ). Prim Care Diabetes 2024; 18:525-532. [PMID: 39054234 DOI: 10.1016/j.pcd.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND The epidemiology data and global burden of diabetic foot disease underscores the need for effective prevention strategies, which requires an early diagnosis. Patient-reported outcome measures are instruments based on a simple format, which favours their application. Currently, there is an absence of instruments with a broad enough scope to capture the diverse aspects involved in diabetic foot disease. OBJECTIVES To develop a questionnaire for the assessment of patients with diabetic foot disease and carry out an analysis of its validity and reliability. METHODS The study was developed in two stages. Stage 1: the Delphi Panel was composed of 22 experts. The questionnaire is made up of 25 questions selected, after three rounds, from an initial sample of 68 questions. Stage 2: A validation study was performed. With a sample of 273 subjects, an exploratory factor analysis and an analysis of internal consistency, items response, and validity were carried out using the Diabetes Quality of Life, SF-12v2, Foot Function Index and EuroQol EQ5D questionnaires. Measurements of error and sensitivity to change were also analyzed. RESULTS A 25-item questionnaire (DiaFootQ) was developed. It comprised two dimensions: 1) lifestyle and function; and 2) footwear and foot self-care. Sample (n=273) mean age was 69.77 years (±11.08). The internal consistency of DiafootQ was α=0.916, and item response values were ICC=0.862-0.998. External validity correlation levels ranged from r=0.386 to r=0.888. CONCLUSION DiaFootQ was developed. Integrating the main aspects involved in diabetic foot disease could help to detect more accurately the risk or severity of these patients. DiaFootQ is a well-structured, valid, and reliable tool whose use should be promoted in clinical and research settings.
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Affiliation(s)
- María Ruiz-Muñoz
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, 3, Malaga 29010, Spain
| | - Raúl Fernández-Torres
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, 3, Malaga 29010, Spain.
| | - Cynthia Formosa
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Triq Dun Karm, Msida, MSD 2080, Malta
| | - Alfred Gatt
- Department of Podiatry, Faculty of Health Sciences, University of Malta, Triq Dun Karm, Msida, MSD 2080, Malta
| | - Alberto José Pérez-Panero
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, 3, Malaga 29010, Spain
| | - Ana Juana Pérez-Belloso
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/Avenzoar, 6, Seville 41009, Spain
| | - Francisco Javier Martínez-Barrios
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, 3, Malaga 29010, Spain
| | - Manuel González-Sánchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, C/Arquitecto Francisco Peñalosa, 3, Malaga 29010, Spain
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Aksoy M, Büyükbayram Z, Özüdoğru O. Reliability and validity of the Diabetic foot self-care questionnaire in Turkish patients. Prim Care Diabetes 2023; 17:513-517. [PMID: 37302937 DOI: 10.1016/j.pcd.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/26/2023] [Accepted: 06/07/2023] [Indexed: 06/13/2023]
Abstract
AIM This study was conducted to examine the psychometric, properties of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire. METHODS This was a descriptive- methodological study conducted on 193 diabetes patients. Data were collected, using Descriptive, Information Form and Diabetic Foot Self-Care Questionnaire. Data were analyzed using exploratory factor analysis, item-total score correlation, Cronbach's alpha, and test-retest analysis. RESULTS The Diabetic, Foot Self-Care, Questionnaire consists of 16 items and three sub-dimensions. The three sub-dimensions recorded a variance of 58.137%. The total Cronbach's alpha coefficient of the Turkish version of the Diabetic, Foot Self-Care, Questionnaire was 0.87, and Cronbach's alpha values of its sub-dimensions were 0.71 and 0.88. The two-month test-retest credibility interpreted with intra-class correlation was 0.97. CONCLUSIONS It has been shown that the questionnaire is a valid and reliable tool for assessing foot self-care behavior in diabetic patients.
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Affiliation(s)
- Meyreme Aksoy
- Siirt University, Faculty of Health Sciences,Department of Nursing Fundamentals, Siirt, Turkey.
| | - Zeliha Büyükbayram
- Siirt University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Siirt, Turkey
| | - Osman Özüdoğru
- Siirt University, Medical Faculty, Department of Internal Medicine, Siirt, Turkey
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Thungtak R, Wannapakhe J, Lapanantasin S. Thai version of the Questionnaire for Diabetes-Related Foot Disease (Thai Q-DFD): validity and reliability. Heliyon 2021; 7:e07832. [PMID: 34471712 PMCID: PMC8387758 DOI: 10.1016/j.heliyon.2021.e07832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/12/2021] [Accepted: 08/16/2021] [Indexed: 11/27/2022] Open
Abstract
Aims To reduce diabetic foot complications, an annual screening of diabetes-related foot disease (DRFD) should be promoted. The screening tool as the Thai translated Questionnaire for Diabetes-related Foot Disease, Thai Q-DFD, has been established. The study was designed to assess the validity and reliability of the Thai Q-DFD before practical use in the community. Methods One hundred and thirty-nine persons with diabetes volunteered in a concurrent validity testing for agreement in diagnosis between the Thai Q-DFD and the standard clinical examinations. The test-retest reliability (a stability of a tool over time between three days apart) was assessed in 50 volunteers. The agreement in either validity or reliability test was evaluated using kappa coefficient. Results The screening diagnosis as DRFD by the Thai Q-DFD substantially agreed with that by the standard clinical examinations (kappa = 0.71). The Thai Q-DFD also showed high sensitivity (0.92) and specificity (0.78). Additionally, the Thai Q-DFD presented good test-retest reliability for DRFD diagnosis (kappa = 0.74). Conclusions The Thai Q-DFD is comparable to the original English version in terms of concurrent validity and test-retest reliability. Therefore, it can be used for a screening of DRFD in Thai people.
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Affiliation(s)
- Rapeepun Thungtak
- Physical Therapy Division, Faculty of Physical Therapy, Srinakharinwirot University, Ongkharak, Nakhonnayok 26120, Thailand
| | - Jirabhorn Wannapakhe
- Physical Therapy Division, Faculty of Physical Therapy, Srinakharinwirot University, Ongkharak, Nakhonnayok 26120, Thailand
| | - Saitida Lapanantasin
- Physical Therapy Division, Faculty of Physical Therapy, Srinakharinwirot University, Ongkharak, Nakhonnayok 26120, Thailand
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Diabetic foot disease: a systematic literature review of patient-reported outcome measures. Qual Life Res 2021; 30:3395-3405. [PMID: 34109501 DOI: 10.1007/s11136-021-02892-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Diabetic foot disease is one of the most serious and expensive complications of diabetes. Patient-reported outcome measures (PROMs) analyse patients' perception of their disability, functionality and health. The goal of this work was to conduct a systematic review regarding the specific PROMs related to the evaluation of diabetic foot disease and to extract and analyse the values of their measurement properties. METHODS Electronic databases included were PubMed, CINAHL, Scopus, PEDro, Cochrane, SciELO and EMBASE. The search terms used were foot, diabet*, diabetic foot, questionnaire, patient-reported outcome, self-care, valid*, reliabil*. Studies whose did not satisfy the Critical Appraisals Skills Programme (CASP) Diagnostic Study Checklist were excluded. The measurement properties extracted were: Internal Consistency, Test-retest, Inter-rater and Intra-rater, Standard Error of Measurement, Minimum Detectable Measurement Difference, Content Validity, Construct Validity, Criterion Validity and Responsiveness. RESULTS The PROMs selected for this review were 12 questionnaires. The Diabetic foot self-care questionnaire (DFSQ-UMA) and the Questionnaire for Diabetes Related Foot Disease (Q-DFD) were the PROMs that showed the highest number of completed measurement properties. CONCLUSION According to the results, it is relevant to create specific questionnaires for the evaluation of diabetic foot disease. It seems appropriate to use both DFSQ-UMA and Q-DFD when assessing patients with diabetic foot disease.
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Świątoniowska N, Chabowski M, Jankowska-Polańska B. Quality of Foot Care Among Patients With Diabetes: A Study Using a Polish Version of the Diabetes Foot Disease and Foot Care Questionnaire. J Foot Ankle Surg 2021; 59:231-238. [PMID: 31932159 DOI: 10.1053/j.jfas.2019.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/29/2019] [Indexed: 02/03/2023]
Abstract
Diabetic foot syndrome is a common, yet serious complication of diabetes, affecting 4% to 10% of patients with diabetes. Polish Diabetes Association guidelines emphasize the need for prevention among patients with diabetes; a key role is played by consistent education on foot care and ulceration prevention. The Diabetes Foot Disease and Foot Care Questionnaire (DFDFC-Q) is the only research instrument available for comprehensive assessment of foot self-care. The study purposes were to explore the quality of foot care among patients with diabetes and to evaluate the psychometric properties of the Polish version of the DFDFC-Q in adult patients with diabetes. The study included 180 patients (112 females and 68 males, mean age 62 ± 14.1 years) with clinically confirmed diabetes mellitus and was performed between January 2017 and May 2018. The questionnaire was translated into Polis, and evaluated by using Cronbach's α coefficient. Of the 180 patients, 39.7% demonstrated good quality of self-care, 44.7% demonstrated moderate quality, and 15.6% demonstrated low quality. Mean score in the group was 22 ± 4.18 points. Scale reliability as measured by Cronbach's α was 0.672. One hundred thirteen (62.78%) patients inspected their feet daily. Many patients wore improper footwear: flip-flops (69.44%) or sandals (58.89%). The aspect most commonly omitted in diabetes education was inspection of the soles of one's feet using a mirror (17.7%). We found that 16.1% of patients visited a podologist in the past year. Comparative analysis demonstrated that a good-quality foot self-care was associated with high school education (p = .008), not having a partner (p = .046), and adhering to dietary recommendations (p = .014). In the linear regression model, independent predictors of better foot self-care included high school and vocational education (β = 7.439, p = .001 and β = 5.539, p = .014, respectively), marital status (divorced and single: β = 3.496, p = .025, widowed: β = 3.466, p = .048), professional inactivity (retirees: β = 7.679, p = .001; disability pensioners: β = 3.522, p = .049; unemployed: β = 4.631, p = .017), and adhering to a diet (β = 5.065, p = .001). An independent negative predictor (i.e., one associated with lower scores in the questionnaire) was male sex (β = -2.853, p = .024). The Polish version of the DFDFC-Q has moderate psychometric properties, but because of the lack of other available instruments for foot self-care assessment, it can be used in the population of Polish diabetic patients. Better quality of foot self-care is determined by high school education, marital status (not having a partner), and adhering to dietary treatment recommendations.
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Affiliation(s)
- Natalia Świątoniowska
- Doctoral Student and Registered Nurse, Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Mariusz Chabowski
- Associate Professor and Surgeon, Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland; Professor, Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland.
| | - Beata Jankowska-Polańska
- Doctoral Student and Registered Nurse, Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Al-Busaidi IS, Abdulhadi NN, Coppell KJ. Development and Pilot Testing of a Diabetes Foot Care and Complications Questionnaire for Adults with Diabetes in Oman: The Diabetic Foot Disease and Foot Care Questionnaire. Oman Med J 2020; 35:e146. [PMID: 32733697 PMCID: PMC7372393 DOI: 10.5001/omj.2020.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives Diabetic foot disease causes substantial morbidity and mortality, but it can be prevented. Our study examined the frequency of diabetes-related foot problems and foot self-care practices, as reported by consecutive patients attending primary and secondary diabetes services in Muscat, Oman. Methods A cross-sectional survey utilizing a newly developed and pre-tested questionnaire was conducted at eight primary health care centers and one polyclinic (secondary care) in A'Seeb, Muscat. A convenience sample of 353 consecutive Omanis, aged 20 years and above, diagnosed with diabetes were invited to participate in this study. We collected data on clinico-demographic characteristics, patient-reported foot complications, and foot self-care practices. Results Of the 350 patients who agreed to participate (mean diabetes duration 7.9±7.4 years, response rate: 99.2%), 62.3% were female, 57.4% were unemployed, more than half were illiterate (52.9%), and around three-quarters (71.4%) were unsure of the type of diabetes they had. More than half (55.1%) reported having at least one or more sensory peripheral neuropathy symptoms, almost half (49.1%) reported one or more peripheral vascular disease symptoms in the previous month, and 12.5% a history of foot ulceration. Reported foot self-care practices were overall suboptimal; 54.7% did not examine the bottom of their feet each day. Conclusions Although self-reported diabetes-related foot complications were common in this population, foot self-care practices were inadequate. These findings suggest a need for the provision of regular foot care education to patients with diabetes. Future research should explore barriers to recommended foot self-care practices.
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Affiliation(s)
- Ibrahim S Al-Busaidi
- Department of Medicine, Edgar Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of General Medicine, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Nadia N Abdulhadi
- Directorate General of Planning and Studies, Ministry of Health, Muscat, Oman
| | - Kirsten J Coppell
- Department of Medicine, Edgar Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Morales J, Glantz N, Larez A, Bevier W, Conneely M, Fan L, Reed B, Alatorre C, Paczkowski R, Ahmed T, Mackenzie A, Duncan I, Kerr D. Understanding the impact of five major determinants of health (genetics, biology, behavior, psychology, society/environment) on type 2 diabetes in U.S. Hispanic/Latino families: Mil Familias - a cohort study. BMC Endocr Disord 2020; 20:4. [PMID: 31906923 PMCID: PMC6945604 DOI: 10.1186/s12902-019-0483-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In the United States (U.S.), the prevalence of both diagnosed and undiagnosed type 2 diabetes (T2D) is nearly twice as high among Mexican-origin Hispanic/Latino adults compared to non-Hispanic Whites. Rates of diabetes-related complications, e.g., acute stroke and end-stage renal disease, are also higher among Hispanic/Latino adults compared to their non-Hispanic/Latino White counterparts. Beyond genetic and biological factors, it is now recognized that sociocultural influences are also important factors in determining risk for T2D and the associated complications. These influences include ethnicity, acculturation, residence, education, and economic status. The primary objective of this study is to determine the influence of the 5 major determinants of human health (genetics, biology, behavior, psychology, society/environment) on the burden of T2D for Latino families. To achieve this objective, Mil Familias (www.milfamilias.sansum.org/) is establishing an observational cohort of 1000 Latino families, with at least one family member living with T2D. METHODS Specially trained, bilingual Latino/a community health workers (Especialistas) recruit participant families and conduct research activities. Each individual family member will contribute data annually on over 100 different variables relating to their genetics, biology, psychology, behavior, and society/environment, creating a Latino-focused biobank ("Living Information Bank"). This observational cohort study is cross-sectional and longitudinal. Participants are divided into 4 groups: adults age ≥ 18 years with and without T2D, and children age ≥ 7 and < 18 years with and without T2D. Study activities take place through encounters between families and their Especialista. Encounters include screening/enrollment, informed consent, health promotion assessment, laboratory tests, questionnaires, physical activity monitoring, and reflection. DISCUSSION By creating and providing the framework for the Cohort Establishment study, we intend to inform new approaches regarding equity and excellence in diabetes research and care. We will examine the complex set of factors that contribute to the burden of diabetes in Latino families and assess if cardio-metabolic disease risks go beyond the traditional biological and genetic factors. Breaking the code on the interplay of cardio-metabolic risk factors may help not only this fast growing segment of the U.S. population, but also other high-risk populations. TRIAL REGISTRATION Study retrospectively registered at ClinicalTrials.gov (NCT03830840), 2/5/2019 (enrollment began 2/1/2019).
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Affiliation(s)
- Jessikah Morales
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
| | - Namino Glantz
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
| | - Arianna Larez
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
| | - Wendy Bevier
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
| | - Mary Conneely
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
| | - Ludi Fan
- Eli Lilly and Company, Indianapolis, IN USA
| | | | | | | | - Tamim Ahmed
- Santa Barbara Actuaries, Santa Barbara, CA USA
| | | | - Ian Duncan
- Santa Barbara Actuaries, Santa Barbara, CA USA
| | - David Kerr
- Sansum Diabetes Research Institute, 2219 Bath Street, Santa Barbara, CA 93105 USA
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Ortega-Avila AB, Cervera-Garvi P, Ramos-Petersen L, Chicharro-Luna E, Gijon-Nogueron G. Patient-Reported Outcome Measures for Patients with Diabetes Mellitus Associated with Foot and Ankle Pathologies: A Systematic Review. J Clin Med 2019; 8:jcm8020146. [PMID: 30691204 PMCID: PMC6407033 DOI: 10.3390/jcm8020146] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Diabetes mellitus (DM) is a chronic and complex disease, which is a major cause of morbidity and mortality and affects all age groups. It commonly produces secondary effects on the foot, often making daily activities impossible. Patient-reported outcome measures (PROMs) provide a standardised method of obtaining patients’ outlooks on their functional status and wellbeing. Although many instruments have been proposed for obtaining data on persons with DM whose feet are affected by the disease, in many cases the psychometric properties of the instrument have yet to be established. The principal objective of our review was to identify PROMs specific for patients with DM affecting the foot and ankle and to evaluate the psychometric properties and methodological quality of these instruments. Methods: In this systematic review, we investigate studies (published in English or Spanish) based on the use of one or more PROMs specific to foot and ankle pathologies for patients with DM (type I or II). To do so, the databases PubMed, Scopus, CINAHL, PEDro and Google Scholar were searched for studies that analysed psychometric or clinimetric properties in this respect. These were assessed according to Terwee or COSMIN criteria. Results: Of the 1016 studies identified in the initial search, only 11 were finally included in the qualitative review. Analysis according to Terwee and COSMIN criteria showed that the Foot Health Status Questionnaire (FHSQ) presented the greatest number of positive values. Conclusions: The FHSQ is the highest-quality PROM currently available for the foot and ankle, for patients with DM.
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Affiliation(s)
- Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain.
| | - Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain.
| | - Laura Ramos-Petersen
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain.
| | - Esther Chicharro-Luna
- Department of Behavioral Sciences and Health, Miguel Hernández University, San Juan de Alicante, 03550 Alicante, Spain.
| | - Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Penalosa 3, Ampliación de Campus de Teatinos, 29071 Malaga, Spain.
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain.
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A systematic review of measurement properties of patient-reported outcome measures for use in patients with foot or ankle diseases. Qual Life Res 2017; 26:1969-2010. [DOI: 10.1007/s11136-017-1542-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 12/20/2022]
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Lazzarini PA, Ng V, Kinnear EM, Kamp MC, Kuys SS, Hurst C, Reed LF. The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease? J Foot Ankle Res 2014; 7:7. [PMID: 24468080 PMCID: PMC3906769 DOI: 10.1186/1757-1146-7-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 01/22/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Foot disease complications, such as foot ulcers and infection, contribute to considerable morbidity and mortality. These complications are typically precipitated by "high-risk factors", such as peripheral neuropathy and peripheral arterial disease. High-risk factors are more prevalent in specific "at risk" populations such as diabetes, kidney disease and cardiovascular disease. To the best of the authors' knowledge a tool capturing multiple high-risk factors and foot disease complications in multiple at risk populations has yet to be tested. This study aimed to develop and test the validity and reliability of a Queensland High Risk Foot Form (QHRFF) tool. METHODS The study was conducted in two phases. Phase one developed a QHRFF using an existing diabetes foot disease tool, literature searches, stakeholder groups and expert panel. Phase two tested the QHRFF for validity and reliability. Four clinicians, representing different levels of expertise, were recruited to test validity and reliability. Three cohorts of patients were recruited; one tested criterion measure reliability (n = 32), another tested criterion validity and inter-rater reliability (n = 43), and another tested intra-rater reliability (n = 19). Validity was determined using sensitivity, specificity and positive predictive values (PPV). Reliability was determined using Kappa, weighted Kappa and intra-class correlation (ICC) statistics. RESULTS A QHRFF tool containing 46 items across seven domains was developed. Criterion measure reliability of at least moderate categories of agreement (Kappa > 0.4; ICC > 0.75) was seen in 91% (29 of 32) tested items. Criterion validity of at least moderate categories (PPV > 0.7) was seen in 83% (60 of 72) tested items. Inter- and intra-rater reliability of at least moderate categories (Kappa > 0.4; ICC > 0.75) was seen in 88% (84 of 96) and 87% (20 of 23) tested items respectively. CONCLUSIONS The QHRFF had acceptable validity and reliability across the majority of items; particularly items identifying relevant co-morbidities, high-risk factors and foot disease complications. Recommendations have been made to improve or remove identified weaker items for future QHRFF versions. Overall, the QHRFF possesses suitable practicality, validity and reliability to assess and capture relevant foot disease items across multiple at risk populations.
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Affiliation(s)
- Peter A Lazzarini
- Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Rode Road, Chermside, Brisbane, QLD 4032, Australia
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Vanessa Ng
- Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Rode Road, Chermside, Brisbane, QLD 4032, Australia
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - Ewan M Kinnear
- Department of Podiatry, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - Maarten C Kamp
- School of Medicine, The University of Queensland, Brisbane, Australia
- Department of Endocrinology, Metro North Hospital & Health Service, Queensland Health, Brisbane, Australia
| | - Suzanne S Kuys
- Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Rode Road, Chermside, Brisbane, QLD 4032, Australia
- Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - Cameron Hurst
- Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Lloyd F Reed
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Castillo-Tandazo W, Flores-Fortty A, Feraud L, Tettamanti D. Spanish translation, cross-cultural adaptation, and validation of the Questionnaire for Diabetes-Related Foot Disease (Q-DFD). Vasc Health Risk Manag 2013; 9:501-8. [PMID: 24039434 PMCID: PMC3769199 DOI: 10.2147/vhrm.s49749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To translate, cross-culturally adapt, and validate the Questionnaire for Diabetes-Related Foot Disease (Q-DFD), originally created and validated in Australia, for its use in Spanish-speaking patients with diabetes mellitus. PATIENTS AND METHODS The translation and cross-cultural adaptation were based on international guidelines. The Spanish version of the survey was applied to a community-based (sample A) and a hospital clinic-based sample (samples B and C). Samples A and B were used to determine criterion and construct validity comparing the survey findings with clinical evaluation and medical records, respectively; while sample C was used to determine intra- and inter-rater reliability. RESULTS After completing the rigorous translation process, only four items were considered problematic and required a new translation. In total, 127 patients were included in the validation study: 76 to determine criterion and construct validity and 41 to establish intra- and inter-rater reliability. For an overall diagnosis of diabetes-related foot disease, a substantial level of agreement was obtained when we compared the Q-DFD with the clinical assessment (kappa 0.77, sensitivity 80.4%, specificity 91.5%, positive likelihood ratio [LR+] 9.46, negative likelihood ratio [LR-] 0.21); while an almost perfect level of agreement was obtained when it was compared with medical records (kappa 0.88, sensitivity 87%, specificity 97%, LR+ 29.0, LR- 0.13). Survey reliability showed substantial levels of agreement, with kappa scores of 0.63 and 0.73 for intra- and inter-rater reliability, respectively. CONCLUSION The translated and cross-culturally adapted Q-DFD showed good psychometric properties (validity, reproducibility, and reliability) that allow its use in Spanish-speaking diabetic populations.
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Stolt M, Suhonen R, Puukka P, Viitanen M, Voutilainen P, Leino-Kilpi H. Development process and psychometric testing of foot health assessment instrument. J Clin Nurs 2013; 22:1310-21. [DOI: 10.1111/jocn.12078] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Minna Stolt
- Finnish Doctoral Programme in Nursing Science; Department of Nursing Science; University of Turku; Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science; University of Turku; Turku Finland
| | - Pauli Puukka
- National Institute for Health and Welfare Turku; Turku Finland
| | - Matti Viitanen
- Department of Geriatrics; University of Turku; Turku Finland
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Education and implementing evidence-based nursing practice for diabetic patients. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2013; 18:251-7. [PMID: 23983764 PMCID: PMC3748547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Foot ulceration is one of the most common complications associated with diabetes that needs to be managed. In Iran, prevalence of diabetes foot ulcer is 3%. According to studies, evidence-based nursing (EBN) is an effective alternative to facilitate clinical decision making in patient care and may lead to quality improvement in nursing practice. The aims of this study are to assess the effects of EBN education on the knowledge, attitude, and practice of nurses who take care of patient with diabetes foot ulcer. MATERIALS AND METHODS A quasi-experimental study (based on IOWA model as a framework to improve nursing practice) was conducted using a before-and-after design. All of nurses (consisted of 19 baccalaureate nurses) who are working in an endocrinology ward were chosen and taught using EBN approach through different workshops. Before and after educational intervention, the data about nurses' knowledge, attitude, and practice were gathered by questionnaire and then compared. The nurses' performance in patient care was evaluated in 3 months by one checklist. The data were analyzed using descriptive and inferential statistics. RESULTS There were statistically significant differences in knowledge, attitude, and practice of nurses before and after intervention (P = 0.001). The nurses' performance in caring for patient with diabetes foot ulcer, based on clinical guideline, showed the improvement in clinical practice. CONCLUSION Education of EBN can improve the nurse's knowledge and attitude to EBN, and be used as a basis on which to influence the professional practice of nursing.
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