Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study

Health literacy and cognitive function in people with diabetic foot ulcer with focus on knowledge, attitude, and practice in relation to foot self-care

Introduction

Preventative foot self-care is vital for avoiding diabetic foot ulcer episodes and lowering the risk of amputations. Yet, it demands high levels of health literacy and cognitive function.

Objective

To investigate health literacy and cognitive function in persons presenting with a diabetic foot ulcer.

Methods

Participants with type 2 diabetes were recruited from the tertiary foot clinic at Steno Diabetes Center North Denmark. The European Health Literacy Survey Questionnaire and Addenbrooke's Cognitive Examination were applied. A semi-structured interview guide was developed to evaluate foot self-care knowledge, attitude, and practice. The qualitative data were analyzed with a deductive approach based on a qualitative thematic analysis model. Subsequently, an integrated analysis of the quantitative and qualitative results was conducted.

Results

The participants (n = 12) had a mean age of 62.6 ± 8.4 years, and 11 were males. The mean diabetes duration was 15.9 ± 8.9 years. Eight participants had a recurrent diabetic foot ulcer. The health literacy level was sufficient in nine participants, and cognitive function was normal in five participants. Three different profiles related to foot self-care (proactive, active, or passive, respectively) were constructed by the final integrated analysis: a proactive profile refers to taking preventative action in concordance with knowledge and attitude, an active profile to taking action in response to a situation, but challenged by conflicting levels of knowledge and attitude, and a passive profile to not taking action.

Conclusion

The study suggests that people presenting with a diabetic foot ulcer have different foot self-care profiles based on person-specific health literacy, cognitive function, and knowledge, attitude, and practice element characteristics, highlighting the need for individualized education and intervention strategy instead of a one-size-fits-all approach.

Effect of counseling model on diabetic women regarding sexual dysfunction: a quasi-experimental study

BACKGROUND

Complications of diabetes in women have adverse effects on their self-image, quality of life, health, and other social relationships, thereby leading to sexual dysfunction. maternity nurse care can play a critical role in assessing the knowledge about needs for sexual health.

AIM

The present study aims to evaluate the effect of the counseling model on female patients with diabetes regarding sexual dysfunction.

METHOD

A quasi-experimental research design was used to conduct the study at the diabetic and obstetric outpatient clinic in 2 hospitals (Al Salam Port Said General Hospital, Elzohor General Hospital), and in five centers in Port Said City (El-Kuwait Center, Othman Ibnafan Center, El-arab 1 center, El-manakh center, El-arab2 center). A purposive sample of 178 female diabetic patients was included in the study. Two tools were used for collecting data consisted of; (1 interview questionnaire sheet) including personal characteristics, medical history, and present sexual problem of the studied female patients, (and 2 female sexual function index (FSFI).

RESULTS

the current study revealed that there was a high statistical difference between female sexual function in post with mean ± SD (23.3 ± 4.1) compared to pre-educational intervention with mean ± SD (19.5 ± 3.7), while there was a high statistically significant difference among pre- & post-program application regarding female sexual function index (p > 0.001).

CONCLUSION

the counseling model had a positive effect in improving the sexual function among female patients with diabetes.

TRIAL REGISTRATION NUMBER (TRN)

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University (code number: NUR 12/9/2021-6).

The perceptions of living with diabetic foot ulcers: A systematic review and meta-synthesis of qualitative studies

BACKGROUND

Diabetic foot ulcers are associated with decreased quality of life in patients with diabetes and impose a heavy burden on patients, their families, and the health care system. For health providers, a deeper understanding of the perceptions of patients is significant. They can provide better management and direction to patients with diabetic foot ulcers, thus improving their quality of life.

OBJECTIVES

To synthesize the findings of qualitative studies to explore the perceptions of individuals living with diabetic foot ulcers.

DESIGN

A systematic review and meta-synthesis of qualitative studies.

METHODS

Published qualitative research articles were identified in PubMed, CINAHL, Embase, ISI Web of Science, Ovid, and Scopus from inception to January 2022, and bibliographical reports were reviewed. In addition, combing with the search for unpublished studies in the Google Scholar ProQuest Dissertations and Theses Database, we conducted a meta-synthesis.

RESULTS

Fourteen articles were eligible for inclusion, and the total number of included individuals was 226, with ages ranging from 28 to 84 years. The perceptions of individuals with diabetic foot ulcers synthesized four overarching themes and their subthemes: perceptions of diabetic foot ulcers (Realization, Reasons), living with diabetic foot ulcers (Change in life, Physical burdens, Emotional burdens, Economic burdens), coping with diabetic foot ulcers (Hospital attendance, Attitude toward amputation, Treatment, Management), and expectations (Expectation of health-personnel, Future expectation).

CONCLUSIONS

Individuals with diabetic foot ulcers suffer greatly in their physical, psychological, and social aspects. Comprehensive and individualized patient-centered care and appropriate families and social support for patients with diabetic foot ulcers should be provided.

Risk assessment of amputation in patients with diabetic foot

The prevalence of diabetes has increased dramatically over the past decade, especially in developing countries, reaching pandemic proportions. Although has been the most important factor influencing the prevalence of type 2 diabetes, the prevalence of type 2 diabetes is on the increase among younger adults. The subsequent rate of increase with age is variable, which is more evident in societies where the general prevalence of the disease is higher. Based on clinical and statistical data obtained from the patients who were admitted to The First and Second Surgery Wards in the Sibiu County Emergency University Clinical Hospital (Sibiu, Romania) and the Proctoven Clinic (Sibiu, Romania) between January 2018 and December 2020, the present study attempted to devise a risk score that can be applied for the benefit of patients. The ultimate aim was that this risk score may be eventually applied by diabetologists and surgeons to assess the risk of amputation in patients with diabetic foot lesions. An important part in the therapeutic management of diabetic foot injuries is the assessment of risk factors. Using this risk score system devised, the risk factors that were found to exert influence in aggravating diabetic foot injuries are smoking, obesity, dyslipidaemia, unbalanced diabetes mellitus (glycated haemoglobin ≥7.5%), duration of diabetes >5 years, hepatic steatosis and the co-existence of various heart diseases. To conclude, all these risk factors aforementioned can decrease the effectiveness of treatment and can have a significant impact on the quality of life, if they are not well known.

How Can “Community Voices” from Qualitative Research Illuminate Our Understanding of the Implementation of the SDGs? A Scoping Review

In 2015, the United Nations committed to 17 Sustainable Development Goals (SDGs) to drive global development policy and practice. Six years into the implementation of the 15-year agenda, the SDGs are subject to extensive monitoring and research at the national, regional, and global levels using quantitative data sets. In contrast, this scoping review considered the contribution of qualitative research studies published in 2021, utilizing data collected from local, place-based community participants. Qualitative research with community participants connects global policy with place-based experience, thus potentially offering a valuable perspective on SDG implementation. Searches were carried out using the Scopus database to identify studies that explicitly linked their aims and objectives to the SDGs. Fifty-four papers met the criteria for inclusion in the review and were charted, mapped, and analysed. For the majority of studies, data collection was carried out in lower-middle income and low-income countries. The “voices” of community participants highlight tensions and challenges affecting the implementation of the SDGs. Reviewing this body of research as a whole identified opportunities to strengthen future qualitative research that will further illuminate progress towards the SDGs.

Beliefs and self-reported practice of footcare among persons with type II diabetes mellitus attending selected health centres in east Trinidad

Background

It has been documented that nearly 600 million people worldwide are expected to have diabetes mellitus in 2035 and that approximately 140,000 persons aged 20-69 years living with diabetes mellitus in Trinidad and Tobago. It is also indicated that patients with type II diabetes mellitus face a higher risk of diabetic foot neuropathy and foot ulcers which increase the risk of below the knee amputation in persons living with diabetes.

Purpose

The aim of this research project was to explore the beliefs related to footcare and the self-reported footcare practice of persons with type II diabetes mellitus attending selected health centres in East Trinidad.

Method

A survey was used to explore the footcare beliefs and the self-reported footcare practice of persons with type II diabetes mellitus attending selected health centres in East Trinidad (n = 87).

Results

Participants had strong belief regarding susceptibility to foot injury, strong belief regarding the seriousness of complications of foot injury, reported good footcare practice and excellent practice of overcoming barriers to performing footcare. There is a correlation between the belief regarding susceptibility to a foot injury and age (p ≤ 0.05). Also, there is a significant correlation between belief regarding susceptibility to a foot injury, seriousness of complications and self-reported footcare practices (p ≤ 0.05).

Conclusion

This study explores and describes the beliefs and self-reported practices of footcare among individuals with type II diabetes mellitus at selected health centres in East Trinidad. It supports the Health Belief Model as an effective framework for the promotion of appropriate footcare among persons with type II diabetes mellitus.