Objective:The study was aimed to assess the knowledge and attitude toward foot care and evaluate the effectiveness of structured teaching program(STP)on the knowledge and attitude of patients with diabetes mellitus re...Objective:The study was aimed to assess the knowledge and attitude toward foot care and evaluate the effectiveness of structured teaching program(STP)on the knowledge and attitude of patients with diabetes mellitus regarding foot care.Materials and Methods:A preexperimental research design was used in this study,which was conducted in medical-surgical wards of a secondary hospital in Northeast India,Nagaland.A total of 30 subjects were recruited by consecutive sampling technique.A closed-ended structured questionnaire and 5-point Likert scale was used to assess knowledge and attitude toward foot care.A STP was administered after which posttest was done after 24 h.Results:The majority(86.6%)of the participants in the pretest had inadequate knowledge and 80%had negative attitudes toward foot care.After STP,70%had moderately adequate knowledge and 53.3%had a positive attitude regarding foot care.The structured teaching program was effective in improving the knowledge and attitude at P<0.01 which is highly significant and there was a significant association between the pretest level knowledge and duration of diabetes at P<0.01.Conclusion:STP was effective in enhancing the level of knowledge and attitude toward foot care among diabetic inpatients.This type of interaction can be organized at regular intervals to reinforce knowledge and attitude toward foot care among inpatients.展开更多
<strong>Objective:</strong> The aim of this study was to develop and validate a questionnaire for patients with diabetes to assess the foot self-care. <strong>Methods:</strong> A validation stu...<strong>Objective:</strong> The aim of this study was to develop and validate a questionnaire for patients with diabetes to assess the foot self-care. <strong>Methods:</strong> A validation study was carried out in a sample of 200 patients with diabetes. Item analyses included the assessment of difficulty index, discrimination capacity and the correlation of items with the total score of the questionnaire. Factor analysis was used to test construct validity. Test-retest reliability was assessed with a sample of 31 patients. Criterion validity was determined by comparing the scores of patients with a history of foot ulcers with the scores of patients without this complication. <strong>Results:</strong> The internal consistency assessed by the Cronbach’s alpha (0.731) and test-retest reliability (r = 0.714, p = 0.001) for all sections were acceptable. Factor analysis revealed three factors: foot care, footwear and foot-damaging behavior, which explained 54.34% of the variance. All items had factor loading of greater than 0.4. Patients with diabetic neuropathy had a lower score after completing the foot care education questionnaire (Mann-Whitney U, p < 0.001). <strong>Conclusion:</strong> This questionnaire meets the reliability and validity conditions necessary for its application in our patients with diabetes.展开更多
Purpose: To identify factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise program. Methods: The subjects were 21 patients with Type 2 diabetes mellitu...Purpose: To identify factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise program. Methods: The subjects were 21 patients with Type 2 diabetes mellitus (8 males, 13 females). The mean age of the patients was 62.3 ± 12.5 years old. Foot status, physical measurements and daily activities were monitored and several surveys were performed. Results: Changes in foot status were significantly positively correlated with walking at normal speed (r = 0.54, p < 0.05) and fast speed (r = 0.68, p p < 0.05). Foot care showed a significant negative correlation with burden of diet therapy (r = -0.48, p < 0.05) and a significant positive correlation with the self-efficacy of diet therapy (r = 0.65, p < 0.01). Conclusions: Subjects who were fast walkers showed greater changes in foot status. Poor foot care behavior is also related to greater changes in foot status. Regular interventions for foot care are important to improve self-care behavior during an exercise program.展开更多
Diabetics with unilateral lower extremity amputation (LEA) have an increased risk of contralateral re-amputation. Foot care knowledge and practice has been shown to reduce the incidence of amputation. The study aims t...Diabetics with unilateral lower extremity amputation (LEA) have an increased risk of contralateral re-amputation. Foot care knowledge and practice has been shown to reduce the incidence of amputation. The study aims to assess the level of foot care knowledge among diabetics with unilateral LEA. Method: A questionnaire based study involving diabetics with unilateral LEA from August 2015 to August 2017. Demographic data and level of foot care knowledge were assessed. Associations between age, gender, educational level, prior amputation and duration of diabetes with level of foot care knowledge were investigated. The presence of peripheral neuropathy in the contralateral leg was also assessed. Results: A total of 64 patients had unilateral LEA within this period, but only 42 patients completed the study. Twenty-four, 24 (57.1%) were males while 18 (42.9%) were females. Mean age was 58.3 years (SD = 12.0). Fifteen, 15 (35.7%) had secondary, 15 (35.7%) had tertiary education, while 3 (7.1%) and 9 (21.4%) had none and primary education respectively. Below knee amputation (BKA) was the commonest (78.6%), and 35.7% have had a prior amputation. Peripheral neuropathy was present in 71.4% of cases. No participant had a good level of foot care knowledge, while 13 (31%) have a fair knowledge and 29 (69%) have poor knowledge. Only 18 (42%) said they have been taught on foot care. Only duration of diabetes and educational level were significantly associated with level of foot care knowledge. Conclusion: Diabetics with unilateral LEA have poor knowledge of foot care and a high prevalence of peripheral neuropathy. Efforts at education of these susceptible cohorts should be intensified.展开更多
Diabetes mellitus has become a global epidemic of 21st century with dispro- portionately high socioeconomic burden in the developing world. Foot ulcerations secondary to peripheral neuropathy and peripheral vascular d...Diabetes mellitus has become a global epidemic of 21st century with dispro- portionately high socioeconomic burden in the developing world. Foot ulcerations secondary to peripheral neuropathy and peripheral vascular disease have led to devastating health outcomes including amputations. A descriptive survey targeting a sample size of 301 was drawn from the selected health facility. Majority of the respondents were female and aged between 40 and 70 years old. The duration that a patient had lived with diabetes, history of smoking and respondents age was significantly associated with foot ulcers at P-value bare foot in and out of the house, breaking into new shoes, poor inspection of feet were associated with the development of foot ulcers while dressing of blisters with sterile dressings was associated with the prevention of foot ulcers.展开更多
Included: •Description of a health system problem;•Possible options for addressing this problem;•Strategies for implementing these options. Not included: recommendations This policy brief do...Included: •Description of a health system problem;•Possible options for addressing this problem;•Strategies for implementing these options. Not included: recommendations This policy brief does not make recommendations regarding which policy to choose. Who is this policy brief for? Policymakers, healthcare professionals, training institutions and other stakeholders that have an interest in the problem addressed in this evidence-based policy brief, Community leaders, non-governmental organizations. Why was this policy brief prepared? To inform discussions about health policies and programmes in relation to diabetic foot care by summarising relevant literature available on foot care in diabetic patients and possible solutions to reduce amputations. What is an evidence-based policy brief? Evidence based policy briefs bring together global research evidence (from systematic/literature reviews) and local evidence to inform discussions about health policies and programmes. Systematic review: A summary of studies addressing a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise the relevant research, and to collect and analyze data from this research. Executive Summary: The evidence presented in this executive summary is summarized from a full brief.展开更多
Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty...Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty-five patients with type 2 DM, 40 - 75 years of age who were asked to return for a follow-up hospital visit, were allocated to either an SFCEP group (n = 29) or a conventional education program (CEP) group (n = 26). Both of the groups were given foot-care education, monthly for four times in the SFCEP group and in the CEP group one time only by a printed leaflet. The two groups had no statistically significant differences in patient background of the type 2 diabetes history. We evaluated removal rate of skin debris, and the symptoms and conditions of the feet. Results: Between the SFCEP and CEP there were significant differences in removal rate of skin debris (p Conclusion: This study strongly suggests the effectiveness of SFCEP in preventing the occurrence or worsening of diabetic foot diseases.展开更多
PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia and numbness. This study evaluated foot self-care behavior according to severity of diabetic neuropathy. METHODS: We used a hand-held ...PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia and numbness. This study evaluated foot self-care behavior according to severity of diabetic neuropathy. METHODS: We used a hand-held nerve conduction test device DPN check (HDN-1000, Omron) to evaluate severity of diabetic neuropathy. Foot self-care was evaluated using the Japanese SDSCA (the Summary of Diabetes Self-Care Activities measure). Foot self-care comprised visual inspection, washing, wiping interdigital areas, and checking shoes, and was scored according to the number of days self-care which was performed in the previous week. RESULTS: The study evaluated 103 diabetic patients (age: 65.7 years, diabetes duration: 13.9 years, HbA1c: 7.3%). Total scores (out of 28 points) for self-care behavior according to neuropathy severity were 11.8 (Normal: n = 54), 10.6 (Mild: n = 27), 13.3 (Moderate: n = 17), and 10.8 (Severe: n = 5). Foot self-care scores were low in all groups, with particularly low scores in those with severe neuropathy. However, no statistically significant differences were observed. CONCLUSIONS: Foot self-care is essential in diabetes because lesions are more likely to occur in severe neuropathy. Living alone and the presence of recurrent foot lesions are associated with poor survival prognosis. Accordingly, foot-care intervention must take neuropathy severity and lifestyle factors into account. The severity of diabetic neuropathy must be determined and foot-care intervention should take lifestyle factors into account.展开更多
Purpose: The purpose of this study was to describe adherence to self-care for hand-foot syndrome (HFS) and the relationship between self-care and health-related quality of life (QOL). Methods: A cross-sectional study ...Purpose: The purpose of this study was to describe adherence to self-care for hand-foot syndrome (HFS) and the relationship between self-care and health-related quality of life (QOL). Methods: A cross-sectional study was conducted on 105 consecutive outpatients with HFS. To assess self-care for HFS and QOL, the participants were asked to complete self-care and HFS-14 (hand-foot syndrome specific QOL) questionnaires, respectively. Multiple regression models were used to identify the relationship between self-care and QOL. Results: Adherence to self-care for HFS was low, less than 50% for most of the items. Multivariate analysis revealed that poorer self-care (βs = -0.19;P = 0.03), depressive symptoms (βs = 0.43;P βs = 0.20;P = 0.04) were independent predictors of poorer QOL scores. Conclusions: We have identified a need for further research to develop effective programs of self-care in HFS.展开更多
文摘Objective:The study was aimed to assess the knowledge and attitude toward foot care and evaluate the effectiveness of structured teaching program(STP)on the knowledge and attitude of patients with diabetes mellitus regarding foot care.Materials and Methods:A preexperimental research design was used in this study,which was conducted in medical-surgical wards of a secondary hospital in Northeast India,Nagaland.A total of 30 subjects were recruited by consecutive sampling technique.A closed-ended structured questionnaire and 5-point Likert scale was used to assess knowledge and attitude toward foot care.A STP was administered after which posttest was done after 24 h.Results:The majority(86.6%)of the participants in the pretest had inadequate knowledge and 80%had negative attitudes toward foot care.After STP,70%had moderately adequate knowledge and 53.3%had a positive attitude regarding foot care.The structured teaching program was effective in improving the knowledge and attitude at P<0.01 which is highly significant and there was a significant association between the pretest level knowledge and duration of diabetes at P<0.01.Conclusion:STP was effective in enhancing the level of knowledge and attitude toward foot care among diabetic inpatients.This type of interaction can be organized at regular intervals to reinforce knowledge and attitude toward foot care among inpatients.
文摘<strong>Objective:</strong> The aim of this study was to develop and validate a questionnaire for patients with diabetes to assess the foot self-care. <strong>Methods:</strong> A validation study was carried out in a sample of 200 patients with diabetes. Item analyses included the assessment of difficulty index, discrimination capacity and the correlation of items with the total score of the questionnaire. Factor analysis was used to test construct validity. Test-retest reliability was assessed with a sample of 31 patients. Criterion validity was determined by comparing the scores of patients with a history of foot ulcers with the scores of patients without this complication. <strong>Results:</strong> The internal consistency assessed by the Cronbach’s alpha (0.731) and test-retest reliability (r = 0.714, p = 0.001) for all sections were acceptable. Factor analysis revealed three factors: foot care, footwear and foot-damaging behavior, which explained 54.34% of the variance. All items had factor loading of greater than 0.4. Patients with diabetic neuropathy had a lower score after completing the foot care education questionnaire (Mann-Whitney U, p < 0.001). <strong>Conclusion:</strong> This questionnaire meets the reliability and validity conditions necessary for its application in our patients with diabetes.
文摘Purpose: To identify factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise program. Methods: The subjects were 21 patients with Type 2 diabetes mellitus (8 males, 13 females). The mean age of the patients was 62.3 ± 12.5 years old. Foot status, physical measurements and daily activities were monitored and several surveys were performed. Results: Changes in foot status were significantly positively correlated with walking at normal speed (r = 0.54, p < 0.05) and fast speed (r = 0.68, p p < 0.05). Foot care showed a significant negative correlation with burden of diet therapy (r = -0.48, p < 0.05) and a significant positive correlation with the self-efficacy of diet therapy (r = 0.65, p < 0.01). Conclusions: Subjects who were fast walkers showed greater changes in foot status. Poor foot care behavior is also related to greater changes in foot status. Regular interventions for foot care are important to improve self-care behavior during an exercise program.
文摘Diabetics with unilateral lower extremity amputation (LEA) have an increased risk of contralateral re-amputation. Foot care knowledge and practice has been shown to reduce the incidence of amputation. The study aims to assess the level of foot care knowledge among diabetics with unilateral LEA. Method: A questionnaire based study involving diabetics with unilateral LEA from August 2015 to August 2017. Demographic data and level of foot care knowledge were assessed. Associations between age, gender, educational level, prior amputation and duration of diabetes with level of foot care knowledge were investigated. The presence of peripheral neuropathy in the contralateral leg was also assessed. Results: A total of 64 patients had unilateral LEA within this period, but only 42 patients completed the study. Twenty-four, 24 (57.1%) were males while 18 (42.9%) were females. Mean age was 58.3 years (SD = 12.0). Fifteen, 15 (35.7%) had secondary, 15 (35.7%) had tertiary education, while 3 (7.1%) and 9 (21.4%) had none and primary education respectively. Below knee amputation (BKA) was the commonest (78.6%), and 35.7% have had a prior amputation. Peripheral neuropathy was present in 71.4% of cases. No participant had a good level of foot care knowledge, while 13 (31%) have a fair knowledge and 29 (69%) have poor knowledge. Only 18 (42%) said they have been taught on foot care. Only duration of diabetes and educational level were significantly associated with level of foot care knowledge. Conclusion: Diabetics with unilateral LEA have poor knowledge of foot care and a high prevalence of peripheral neuropathy. Efforts at education of these susceptible cohorts should be intensified.
文摘Diabetes mellitus has become a global epidemic of 21st century with dispro- portionately high socioeconomic burden in the developing world. Foot ulcerations secondary to peripheral neuropathy and peripheral vascular disease have led to devastating health outcomes including amputations. A descriptive survey targeting a sample size of 301 was drawn from the selected health facility. Majority of the respondents were female and aged between 40 and 70 years old. The duration that a patient had lived with diabetes, history of smoking and respondents age was significantly associated with foot ulcers at P-value bare foot in and out of the house, breaking into new shoes, poor inspection of feet were associated with the development of foot ulcers while dressing of blisters with sterile dressings was associated with the prevention of foot ulcers.
文摘Included: •Description of a health system problem;•Possible options for addressing this problem;•Strategies for implementing these options. Not included: recommendations This policy brief does not make recommendations regarding which policy to choose. Who is this policy brief for? Policymakers, healthcare professionals, training institutions and other stakeholders that have an interest in the problem addressed in this evidence-based policy brief, Community leaders, non-governmental organizations. Why was this policy brief prepared? To inform discussions about health policies and programmes in relation to diabetic foot care by summarising relevant literature available on foot care in diabetic patients and possible solutions to reduce amputations. What is an evidence-based policy brief? Evidence based policy briefs bring together global research evidence (from systematic/literature reviews) and local evidence to inform discussions about health policies and programmes. Systematic review: A summary of studies addressing a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise the relevant research, and to collect and analyze data from this research. Executive Summary: The evidence presented in this executive summary is summarized from a full brief.
文摘Objective: To verify the effectiveness of a “self-foot-care educational program (SFCEP)” for prevention of type 2 diabetes foot disease. Methods: A single-center, randomized and controlled trial was conducted. Fifty-five patients with type 2 DM, 40 - 75 years of age who were asked to return for a follow-up hospital visit, were allocated to either an SFCEP group (n = 29) or a conventional education program (CEP) group (n = 26). Both of the groups were given foot-care education, monthly for four times in the SFCEP group and in the CEP group one time only by a printed leaflet. The two groups had no statistically significant differences in patient background of the type 2 diabetes history. We evaluated removal rate of skin debris, and the symptoms and conditions of the feet. Results: Between the SFCEP and CEP there were significant differences in removal rate of skin debris (p Conclusion: This study strongly suggests the effectiveness of SFCEP in preventing the occurrence or worsening of diabetic foot diseases.
文摘PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia and numbness. This study evaluated foot self-care behavior according to severity of diabetic neuropathy. METHODS: We used a hand-held nerve conduction test device DPN check (HDN-1000, Omron) to evaluate severity of diabetic neuropathy. Foot self-care was evaluated using the Japanese SDSCA (the Summary of Diabetes Self-Care Activities measure). Foot self-care comprised visual inspection, washing, wiping interdigital areas, and checking shoes, and was scored according to the number of days self-care which was performed in the previous week. RESULTS: The study evaluated 103 diabetic patients (age: 65.7 years, diabetes duration: 13.9 years, HbA1c: 7.3%). Total scores (out of 28 points) for self-care behavior according to neuropathy severity were 11.8 (Normal: n = 54), 10.6 (Mild: n = 27), 13.3 (Moderate: n = 17), and 10.8 (Severe: n = 5). Foot self-care scores were low in all groups, with particularly low scores in those with severe neuropathy. However, no statistically significant differences were observed. CONCLUSIONS: Foot self-care is essential in diabetes because lesions are more likely to occur in severe neuropathy. Living alone and the presence of recurrent foot lesions are associated with poor survival prognosis. Accordingly, foot-care intervention must take neuropathy severity and lifestyle factors into account. The severity of diabetic neuropathy must be determined and foot-care intervention should take lifestyle factors into account.
文摘Purpose: The purpose of this study was to describe adherence to self-care for hand-foot syndrome (HFS) and the relationship between self-care and health-related quality of life (QOL). Methods: A cross-sectional study was conducted on 105 consecutive outpatients with HFS. To assess self-care for HFS and QOL, the participants were asked to complete self-care and HFS-14 (hand-foot syndrome specific QOL) questionnaires, respectively. Multiple regression models were used to identify the relationship between self-care and QOL. Results: Adherence to self-care for HFS was low, less than 50% for most of the items. Multivariate analysis revealed that poorer self-care (βs = -0.19;P = 0.03), depressive symptoms (βs = 0.43;P βs = 0.20;P = 0.04) were independent predictors of poorer QOL scores. Conclusions: We have identified a need for further research to develop effective programs of self-care in HFS.