Ten Rules of Foot Care—The Development of a Short Questionnaire for Patients with Diabetes

Objective: The aim of this study was to develop and validate a questionnaire for patients with diabetes to assess the foot self-care. Methods: 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. Results: 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). Conclusion: This questionnaire meets the reliability and validity conditions necessary for its application in our patients with diabetes.

Factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise health education program

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.

Assessment of Foot Care Knowledge among Diabetic Amputees at National Orthopaedic Hospital Enugu

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.

Foot Care Practices among Type 2 Diabetics Mellitus Patients Attending Diabetes Clinics in Embu County, Kenya

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.

An Evidence-Based Policy Brief Improving Foot Care in Diabetic Patients: Reduces Amputations

Included: &bull;Description of a health system problem;&bull;Possible options for addressing this problem;&bull;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.

Effectiveness of structured teaching program on knowledge and attitude toward foot care

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.

Effectiveness of a Self-Foot-Care Educational Program for Prevention of Diabetic Foot Disease

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.

Effect of Foot Self-Care Behavior According to Severity of Diabetic Neuropathy in Japanese Patients with Diabetes

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.

Relationship between Self-Care and Hand Foot Syndrome Specific Quality of Life in Cancer Patients

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.

糖尿病足坏疽患者一例的居家安宁疗护实践

本文总结1例糖尿病足坏疽患者进行中医药特色的居家安宁疗护实践体会,护理要点包括入户指导家属对患者进行糖尿病足照护、帮助患者建立预立医疗计划、为患者及家属提供家庭尊严疗法、灵性照护、哀伤抚慰等,使患者有尊严、无遗憾、安详地离世;同时,减轻家属照护压力,缩短其哀伤过程。

北京市某社区2型糖尿病患者足部护理知识与行为状况调查及影响因素分析

目的调查北京市新街口社区2型糖尿病患者足部护理知识与行为状况并分析其影响因素。方法采用方便取样法选取北京市新街口社区的278例糖尿病患者进行问卷调查,调查内容包括患者的一般资料、足部护理知识和行为。结果278例患者的足部护理知识平均得分为(71.65±14.59)分,整体处于中等水平,足部护理行为平均得分为(48.83±8.83)分,整体处于较差水平。多元逐步回归分析结果显示,性别、病程、是否接受过足部护理教育均为社区糖尿病患者足部护理知识得分、足部护理行为得分的独立影响因素(P<0.05)。Pearson相关分析结果显示,社区糖尿病患者足部护理知识与足部护理行为呈正相关(r=0.593,P<0.001)。结论北京市该社区糖尿病患者足部护理知识水平中等,足部护理行为状况不容乐观。社区医护人员应加强足部护理健康教育,提升患者的足部护理知识水平和足部护理行为依从性,同时应关注男性、病程较短的糖尿病患者,以减少糖尿病足的发生。

以Triangle模型为基础的分级护理应用于糖尿病足患者的效果

目的观察并分析以Triangle模型为基础的分级护理应用于糖尿病足患者的效果。方法选取漯河市中心医院2021年12月至2023年12月收治的97例糖尿病足患者,按照抽签法分组,常规组48例接受常规护理,研究组49例患者接受以Triangle模型为基础的分级护理,均干预3个月后,比较两组溃疡修复情况、神经传导速度、自我效能、并发症及生活质量。结果研究组感觉检查、症状以及反射评分低于常规组(P<0.05)。研究组胫神经、腓总神经传导速度快于常规组(P<0.05)。研究组3个月后自我减压、自我决策、正性态度及生活质量评分均高于常规组(P<0.05)。研究组10 g尼龙绳触觉、痛觉、冷热觉及振动觉异常和下肢麻木发生率低于常规组(P<0.05)。两组皮肤干燥情况差异无统计学意义(P>0.05)。结论以Triangle模型为基础的分级护理可明显提高糖尿病足患者自我效能,有利于其溃疡修复和神经传导速度改善,减少并发症发生并促进生活质量的提高。

足部骨折患者运用快速康复外科理念护理干预的效果评估

目的 探究快速康复外科护理对足部骨折患者的影响。方法 简单随机选取2021年5月—2022年5月就诊于聊城市人民医院的90例足部骨折患者为研究对象。利用随机抽签法分组,两组各45例。给予对照组常规护理,给予观察组快速康复外科护理。对两组足部功能、术后并发症情况和生活质量进行比较。结果观察组干预后3、6、12个月的足部功能评分依次为(60.45±5.73)分、(76.41±5.91)分、(84.67±5.11)分,比对照组的(55.67±5.52)分、(64.15±5.62)分、(77.64±4.92)分高,差异有统计学意义(t=4.030、10.084、6.648,P均<0.05)。观察组总并发症发生率比对照组低,差异有统计学意义(P<0.05)。观察组生活质量评分显著比对照组高,差异有统计学意义(P<0.05)。结论 快速康复外科护理有利于促进足部骨折患者足功能的恢复与提高,降低并发症发生率,患者生活质量更好。

26例儿童病毒感染后双足神经病理性疼痛的护理

总结26例低温天气病毒感染后双侧足趾神经病理性疼痛患儿的护理经验。护理主要内容如下:控制症状,促进神经修复;提高病人认知,强化健康教育;加强心理护理,调动积极情绪。经过精心的治疗和护理,26例病人均恢复良好,康复出院。

广西重症手足口病患儿接受重症监护及出现死亡的危险特征分析

目的:分析重症手足口病(HFMD)患儿在不同临床症状和体征下,进入重症监护室(ICU)及死亡的风险,为重症HFMD患儿接受重症监护与不同临床转归的危险体征识别提供参考。方法:在2014-2018年间,通过现场调查方法,对广西各县(市、区)重症住院的HFMD确诊患儿进行了连续的个案调查;采用Epidata软件对调查资料进行双录入;使用二分类logistic回归分析,比较重症HFMD患儿不同的临床症状和体征与其死亡或被收入ICU的风险(比值比,OR),明确哪些临床症状体征导致患儿更可能进入ICU及更容易死亡。结果:2014—2018年共调查广西各县(市、区)重症HFMD病例1 500例,男女性别比例为1.78∶1;发病年龄中位数为1.85岁(0~11岁)。与未出现这些症状的患儿相比,共济失调、谵妄、口唇紫绀、面色苍灰、嗜睡、无力麻痹、肢体抖动、易惊是患儿进入ICU的危险症状体征(OR分别为4.924、4.515、2.781、2.750、2.311、2.162、2.139、1.361)。血性泡沫痰、呼吸浅促、面色苍灰、口唇紫绀、呕吐是预示死亡风险增加的危险症状(OR分别为19.045、5.438、3.175、3.031、2.621)。结论:重症HFMD患儿如出现共济失调、谵妄、口唇紫绀等症状,其病情进一步发展为危重症的概率更高,并需接受重症监护治疗;如出现血性泡沫痰、呼吸浅促、面色苍灰、口唇紫绀、呕吐等症状时,应重点关注病情是否恶化而导致死亡。

人文关怀护理对糖尿病足患者焦虑抑郁情绪效果观察

目的运用人文关怀护理干预缓解糖尿病足患者焦虑抑郁情绪。方法选取于2022年1月—2023年4月医院收治的糖尿病足患者100例为研究对象,随机分组为对照组和观察组,各50例。对照组接受常规治疗和护理,观察组在对照组基础上增加人文关怀护理。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者焦虑抑郁情绪。结果干预后,两组SAS和SDS量表评分均较干预前下降,且观察组SAS和SDS量表评分低于对照组,差异有统计学意义(P<0.01)。结论人文关怀护理能有效改善糖尿病足患者焦虑抑郁情绪,增强积极应对方式,从而有利于改善生活质量。

低分子肝素钙联用哌拉西林钠他唑巴坦钠致重度血小板减少个案分析

目的为临床安全使用低分子肝素钙及哌拉西林钠他唑巴坦钠提供参考。方法回顾性分析亳州市中医院收治的1例低分子肝素钙联用哌拉西林钠他唑巴坦钠致重度血小板减少的老年男性糖尿病足患者的治疗过程。结果患者因右足溃烂1个月入院[入院时血小板计数(PLT)较高,为571×10^(9)/L],在常规予胰岛素降血糖的同时,根据尿细菌培养及药物敏感性试验结果,给予注射用哌拉西林钠他唑巴坦钠(4.5 g,静脉滴注,每8 h 1次)和低分子肝素钙注射液(4000 AⅩaIU,皮下注射),治疗12 d后PLT降至14×10^(9)/L(重度血小板减少),考虑与上述2种药物联用有关,停用4 d后,PLT升至52×10^(9)/L,6 d后PLT恢复正常。结论临床联用低分子肝素钙及哌拉西林钠他唑巴坦钠时应考虑导致重度血小板减少的可能性,应密切监测患者血常规及临床表现,及时处理。

奥瑞姆自我护理模式在糖尿病足部溃疡患者护理中的应用

目的探讨在糖尿病足部溃疡患者中应用奥瑞姆自我护理模式,观察其对患者的康复、感染率和生活质量的影响。方法选取2021年9月—2022年5月于莆田学院附属医院内分泌科治疗的糖尿病足部溃疡患者46例作为研究对象。按照随机数字表法分为奥瑞姆自我护理组与对照组,各23例。对照组接受常规自我护理宣教,奥瑞姆自我护理组接受奥瑞姆自我护理模式宣教。比较2组干预前后血糖相关指标、足部溃疡创面愈合时间及细菌培养阳性率和生活质量评分。结果与对照组比较,奥瑞姆自我护理组显著改善患者的空腹血糖、餐后2 h血糖以及糖化血红蛋白水平(P<0.05)。奥瑞姆自我护理组的足部溃疡创面愈合时间为(32.74±5.24)d,与对照组的(40.36±3.67)d比较,明显缩短,创面细菌阳性率显著下降(P<0.05)。同时,与对照组比较,奥瑞姆自我护理组的患者生活质量显著提高(P<0.05)。结论奥瑞姆自我护理模式在糖尿病足部溃疡患者护理中展现出显著的积极影响,包括改善血糖控制、缩短愈合时间、降低感染风险以及提高生活质量。这一模式为改善糖尿病足部溃疡患者的护理提供了有力的工具,有望减轻患者的痛苦、降低医疗成本,提高患者的整体康复和生活质量。

重症糖尿病足伤口护理中精细化干预的应用及对控制血糖水平的影响

目的分析探究在重症糖尿病足伤口护理中精细化干预的应用及对控制血糖水平的影响。方法选取2022年7月—2023年8月兰陵县人民医院重症医学科收治的80例重症糖尿病足患者为研究对象,以随机数表法分参照组(40例)和研究组(40例)。参照组采取常规干预,研究组采取精细化干预,对比两组干预效果。结果干预后,研究组血糖水平低于参照组,差异有统计学意义(P<0.05);研究组心理状态评分低于参照组,差异有统计学意义(P<0.05);研究组生活质量评分高于参照组,差异有统计学意义(P<0.05)。结论针对重症糖尿病足伤口,经精细化干预,效果确切。

基于专科联盟的慢性伤口管理模式在糖尿病足病人护理中的应用

目的:探讨基于专科联盟的慢性伤口管理模式在糖尿病足病人护理中的应用。方法:选取2020年1月—2022年12月医院内分泌科收治的糖尿病足病人86例,应用随机数字表法将病人分为观察组及对照组各43例。对照组行常规性伤口护理,观察组实施基于专科联盟的慢性伤口管理模式,比较两组病人足部护理知识、足部自我护理能力、足部溃疡面愈合情况。结果:与对照组比较,观察组干预后足部护理知识评分、足部自我护理能力总评分显著提升(P<0.05),而观察组干预后足部皮肤及趾甲状况评分、IWGDF糖尿病足部风险分级评分较对照组显著下降(P<0.05)。结论:基于专科联盟的慢性伤口管理模式可提升糖尿病足病人足部护理知识及自我护理能力,有效预防足部溃疡。