Evaluation of patients' education on foot self-care status in diabetic patients

Assessment of knowledge and foot self-care practices among diabetes mellitus patients in a tertiary care centre in Makkah, Saudi Arabia: a cross-sectional analytical study

Introduction

diabetic foot is a common long-term complication of uncontrolled diabetes mellitus. Knowledge about foot self-care practices among diabetic patients in Saudi Arabia is limited. Thus, the aim of this study was to assess the level of patients´ knowledge and practices regarding self-care of diabetic foot among diabetic patients.

Methods

a cross-sectional analytical study was conducted using a sample of diabetic patients attending outpatient clinics at Heraa Diabetic Center, Ministry of Health, Makkah City, Saudi Arabia from June 2020 to July 2020. The participants were interviewed through a self-administered questionnaire inquiring sociodemographic factors, patients´ knowledge and practices regarding foot self-care.

Results

a total of 409 patients were included in this study. Respondents' ages ranged between 6 and 75 years with a mean of 42.5 years and standard deviation of 13.9 years. Females represented 51.1% of the participants. Type 2 diabetes represented 85.6% of the responses. Overall, most of the participants (72.4%) had a poor level of knowledge whereas only 4.2% expressed a good level of knowledge. Being employed (P = 0.046), type II diabetes patients (P = 0.047) and those whose main source of information was health staff (P = 0.026) were more knowledgeable compared to their peers. Almost two-thirds (63.3%) of patients showed a poor level of practice related to diabetic foot self-care.

Conclusion

low level of knowledge and practice of foot care are prevalent among diabetic patients attending outpatient clinics at Heraa Diabetic Center. Designed interventions should be implemented to enhance diabetic foot self-care.

Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

BACKGROUND

Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided.

AIM

We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research.

METHOD

Using a systematic review methodology, we searched six databases for full-text papers from 2009-2019 published in peer-reviewed journals with no limits on language.

RESULTS

Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care.

CONCLUSIONS

The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

Knowledge and practice of foot care in patients with diabetes mellitus attending primary care center at Security Forces Hospital, Riyadh, Saudi Arabia: A cross-sectional study

Introduction and Objectives:

Methodology:

Results:

Conclusions:

Patient Health Literacy and Diabetic Foot Amputations

Patient health literacy is associated with self-care and management of chronic diseases, including diabetes. Interventions that address health literacy and aim to improve clinical outcomes have been focused mostly in primary care. The purpose of this study was to explore the association between patient health literacy and diabetic foot amputations in a retrospective cohort analysis in a large orthopaedic practice at an academic medical center. Using data extraction from clinical records, orthopaedic patients who had a diabetic foot amputation or re-amputation in the last 2 years were compared with the general orthopaedic patient population, with patient health literacy screening results as the dependent variable. Results revealed a statistically significant difference in health literacy between the foot amputee group (N = 177) and the general orthopaedic patient group (N = 14,683) (p < .0001). Patients in the foot amputee group were 8.07 times more likely to have inadequate health literacy than patients in the general orthopaedic patient group. Because diabetic amputations are frequently associated with poorly controlled diabetes, these results provide a strong rationale to develop health literacy-based interventions that address diabetes self-management and foot exams in orthopaedic practices to improve clinical outcomes, including amputation prevention.

The effect of short message service (SMS) on knowledge and preventive behaviors of diabetic foot ulcer in patients with diabetes type 2

OBJECTIVE

The present study aimed at evaluating the effectiveness of an educational intervention via mobile cells on foot care knowledge and foot care practices in patients with type 2 diabetes.

MATERIAL AND METHODS

This is an interventional quasi-experimental study carried out in 4 community health centers in Andimeshk City in Iran in 2017. Of 160 patients 80 cases were randomly assigned as intervention group and 80 patients as the control one. A three-section questionnaire completed by a face-to-face interviewing used for data collection before and after the intervention and three months after the education. Fasting Blood Sugar (FBS) and Hemoglobin A1C (HbA1c) tests were done for both groups in a single laboratory before and three months after training.

RESULTS

The mean age of patients in intervention group was 48.11 ± 9.7 and control group was 47.3 ± 7.9 years. The awareness of the patients related to diabetes foot care, in the intervention group after the training significantly improved (P < 0.001). The mean scores of preventive behaviors of diabetic foot significantly increased in the intervention group (P < 0.001).

CONCLUSION

The findings indicate that educational intervention based on short message service (SMS), resulting in improve foot care knowledge, foot care practices and metabolic control in patients with diabetes type 2.

Challenges of foot self-care in older people: a qualitative focus-group study

Background

Foot health is an important aspect of general health, and it can be maintained and promoted through foot self-care. However, little is known about older people’s experiences of caring for their feet. The aim of this study was to gather knowledge about experiences of foot self-care from the perspective of healthy older people in order to improve their welfare and their management of foot health.

Methods

A qualitative descriptive design with focus groups was used. Seventeen older people recruited from daytime activity centres participated in the focus groups (n = 4). The data were analysed using inductive content analysis.

Results

The participants described their foot self-care as including various activities, but they were hindered by the following factors: physical (e.g. changes in nail structure), external (e.g. seeking help from multi-level professionals) and internal (e.g. related to ageing). Foot self-care was considered to be important, but it was not systematically carried out. The participants thought that health-care professionals neglected patients’ feet.

Conclusions

Older people use a variety of methods to care for their feet. However, several factors hinder their ability to do so. Older people need advice, education and support to maintain their foot health. Future research is needed to identify effective ways to support older people in foot self-care and improve their welfare as active citizens.

Knowledge and practice about the foot care and the prevalence of the neuropathy among a sample of type 2 diabetic patients in Erbil, Iraq

CONTEXT

Patients with diabetes need to receive medical care from collaborative, integrated teams with expertise in diabetes. They must also assume an active role in their care. One aspect of health education for diabetic patients is foot care, therefore identifying patients foot care knowledge and practice is central in diabetes management.

AIMS

To know level of foot care, to assess peripheral neuropathy and association between them.

SETTINGS AND DESIGN

Cross sectional study in Rizgary Teaching Hospital and Layla Qasim diabetic center in Erbil, Iraq.

SUBJECTS AND METHODS

A sample of 250 patients aged ≥ 18 years with type 2 diabetes were interviewed to complete a questionnaire about foot care. Then a Michigan Neuropathy Screening Instrument was used as screening tool to detect neuropathy.

STATISTICAL ANALYSIS USED

Statistical Package for Social Sciences version 25 used with a statistical significance level of < 0.05. The results presented as rates, frequencies, percentages in tables and analyzed using Chi-square test.

RESULTS

The mean age of the sample was 53.75 ± 12.08 years. The mean knowledge and practice scores were 6.1 ± SD 2.6 and 5.8 ± SD 2.1, respectively. The majority of participants were of poor knowledge score and moderate practice score (38% and 40%, respectively). The percentage of neuropathy was 31.20%. The neuropathy was highest among those who had low knowledge score (P < 0.05).

CONCLUSIONS

The mean knowledge and practice scores were moderate, knowledge had significant influence on practice. Peripheral neuropathy was significantly higher among those with low knowledge score.

Foot care behaviors among adults with type 2 diabetes

AIM

The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes.

METHODS

A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014.

RESULTS

Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management.

CONCLUSION

Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems.

Improving diabetic foot screening at a primary care clinic: A quality improvement project

Background

Foot screening is an important part of diabetic care as it prevents significant morbidity, loss of function and mortality from diabetic foot complications. However, foot screening is often neglected.

Aim

This project was aimed at educating health care workers (HCWs) in a primary health care clinic to increase diabetic foot screening practices.

Setting

A primary health care clinic in the Western Cape province of South Africa

Methods

A quality improvement project was conducted. HCWs’ needs were assessed using a questionnaire. This was followed by focus group discussions with the HCWs, which were recorded, transcribed and assessed using a general inductive approach. An intervention was designed based on common themes. Staff members were trained on foot screening and patient information pamphlets and screening tools were made available to all clinic staff. Thirty-two consecutive diabetic patient folders were audited to compare screening in 2013 with that in 2014 after initiation of the quality improvement cycle.

Results

HCWs’ confidence in conducting foot screening using the diabetic foot assessment questionnaire improved markedly after training. Diabetic foot screening practices increased from 9% in 2013 to 69% in 2014 after the first quality improvement cycle. A strengths, opportunities, aspirations and results (SOAR) analysis showed promise for continuing quality improvement cycles.

Conclusion

The findings showed a significant improvement in the number of diabetic patients screened. Using strategic planning with appreciative intent based on SOAR, proved to be motivational and can be used in the planning of the next cycle.

Factors associated with diabetic foot amputations

BACKGROUND: Diabetes and the problem of the diabetic foot specifically are a severe burden on the public healthcare system. Amputations caused by this condition are still common in our setting (Brazil), although the true magnitude of the problem is not known with certainty. Lower limb amputation rates have come to be seen as an indicator of the quality of preventative care of the diabetic foot. OBJECTIVE: To identify associations between amputations and factors related to people, to morbidities and to primary care received. METHODS: This was a cross-sectional study of a sample of 137 patients with diabetic feet admitted to a large hospital in the city of Recife, Pernambuco, Brazil. Logistic regression analysis was conducted. RESULTS: Associations with amputation were detected for the following variables: age over 60; resident of the Metro zone; income of three minimum salaries or less; presence of gangrene on admission; glycemia ≥ 126 mg/dL; smoking; not receiving information about results of glycemia testing; not having feet examined, and not being given guidance on caring for feet at consultations during the previous year. CONCLUSIONS: Factors related to Primary Care, such as time since onset of ulcers, information about results of glycemia testing and lack of guidance on how to care for their feet, were associated with occurrence of lower limb amputations.