scholarly journals A PROSPECTIVE STUDY: KNOWLEDGE ASSESSMENT AND PATIENT CARE OF DIABETIC FOOT ULCER PATIENTS IN TERTIARY CARE HOSPITAL

Author(s):  
Sheena Marin Thomas ◽  
Ishita Gajjar Nitin ◽  
M. Uday Kiran Reddy ◽  
Harsha Devi S.

Objective: To assess the knowledge with a diabetic foot ulcer, to evaluate the severity and grade of diabetic foot ulcer, to study the self-care behaviour and medication adherence in a patient with diabetic foot ulcer and to counsel the patients.Methods: The KAP, self-care foot behaviour and MMAS-8 questionnaire were given during interview; severity using Wagner’s scale was assessed. Knowledge, attitude, self-care foot practice and adherence was measured based on various parameters such as demographic factors, clinical characteristics, and medication taking characteristics. It was measured before and after the patient counselling to see improvement in the quality of life.Results: In the study period of 6 mo 111 cases were gathered. There were 74 (66%) patients who were illiterate; the patients with low economic status were 63 (56%). Patients who are illiterate have poor knowledge and poor self-care behaviour, in our study 74 (66%) are illiterate which improved after counselling and 59 patients with high knowledge. Medication adherence is also associated with the education of the patient. After counselling and providing knowledge most of the patients are having high KAP scores. Wagner’s scale for the study of the severity shows that most of the patients 30 out of 111 are having Grade 4 of the score which shows the need of counselling and education towards foot care. Improvement in the self-care practice and on safety and prevention was seen after counselling.Conclusion: Knowledge, attitude, self-care practice and adherence of the patient can be improved by establishing a good patient-provider relationship and giving proper patient counselling to the patient or their relatives.

2021 ◽  
Author(s):  
Ida Ayu Kshanti ◽  
Nanang Soebijanto ◽  
Nadya Magfira ◽  
Marina Epriliawati ◽  
Jerry Nasarudin ◽  
...  

ABSTRACTBackground and aimThe awareness and practice of diabetes foot prevention by internist through routine examination and patient education remains less than optimal. This study aimed to evaluate the quality of care of internist in performing foot care in high-risk patients.MethodsA cross sectional study was conducted in a tertiary care hospital in Jakarta, Indonesia. Type 2 diabetes mellitus subjects with high-risk foot complication were included in this study. Each subject filled-in a questionnaire investigating whether they had received information about proper foot care practice and whether they have ever had their feet examined by an internist at their present consultation. Multivariate logistic regression were performed.Results368 patients were recruited, 130 of them (35.3%) treated by endocrinologists. 71.20% patients did not received any information on foot care and 54.08% patients did not received any foot examination. Foot care information was 1.6 times more frequently provided to patient with longer diabetes duration and 2 times more frequently provided to those who had history of diabetic foot ulcer. Meanwhile, foot examination was 1.5 times more frequently provided to those with longer diabetes duration and had a history of Lower Extremity Amputation. Compare to non-endocrinologist internist, endocrinologists tend to provide foot education and perform foot examination 2.2 to 2.5 times more frequently than non-endocrinologists.ConclusionMost of patients with high risk foot problems were not offered adequate foot care. It is necessary to develop strategies to improve the care and awareness among health professionals treating patients with diabetes especially internist.


2021 ◽  
Vol 44 (4) ◽  
pp. E11-16
Author(s):  
Muzammil H. Syed ◽  
Mohammed Al-Omran ◽  
Jean Jacob-Brassard ◽  
Joel G. Ray ◽  
Mohamad A. Hussain ◽  
...  

Purpose: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU). Methods: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)—each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated. Results: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups. Conclusion: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.


2018 ◽  
Vol 5 (11) ◽  
pp. 3608
Author(s):  
Shanmuga Raju P. ◽  
Venkata Ramana N. ◽  
Surya Narayana Reddy V. ◽  
Bhagya Seela S. ◽  
Sachin G.

Background: Diabetic foot ulcer is a painful, demands increased health care utilization, and increases healthcare costs for the patients as well as the health care system. The purpose of this study was to analysis the prevalence of diabetic foot complications and risk factors among diabetic patients at tertiary care Hospital, Karimnagar.Methods: Total 60 sample sizes were included in the study. The study was conducted at General Surgery ward, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar from July 2017 to June 2018. Demographic, complications and risk factors were recorded, and outcomes were analyzed using SPSS statistics version 21.0.Results: The Mean age of the study group is 50.31±14.26 years. The male to female distribution is 47 (78.3%) and 13 (21.7%) respectively. The mean duration of illness in days is 96.68±289.21, while mean HbA1C is 9.44±9.02. The mean fasting blood sugar and postprandial blood sugar is 159.78±70.01 and 157.78±86.28 which shown no significance difference (p = 0.87). Odds ratio with 95% confidence interval was computed to the level of significant.Conclusions: There was no significant outcome was found in diabetic foot ulcer. Patient with high risk complications need as early detection, foot care education, moderate physical, exercise, fitted foot wear and diabetic diet should be decrease the risk of diabetic foot ulcers.


2021 ◽  
Vol 9 (3) ◽  
pp. 293
Author(s):  
Arisvia Sukma Hariftyani ◽  
Hermina Novida ◽  
Mouli Edward

Background: Diabetic Foot Ulcer (DFU) has been associated with a high mortality rate of Diabetes Mellitus (DM) patients. Both behavioral and biological factors cause predisposition to DFU. Purpose: This research describes the profile of hospitalized DFU patients at a tertiary care hospital in Surabaya. Methods: A retrospective descriptive study that analyzed medical records of hospitalized T2DM patients with DFU in Dr. Soetomo General Hospital. Sampled respondents were patients ≥ 21 years old who were hospitalized between 2016–2018. Demographic data, clinical characteristics, medical histories, length of hospital stay, laboratory results, precipitating factors, microorganism culture results, treatment, and outcome were analyzed. Descriptive analysis is presented in the form of narratives, tables, and diagrams. Results: 9.08% of hospitalized Type 2 DM (T2DM) cases were related to foot ulcers. The average patient age was 57.00 ± 9.83 years with no gender predominance. DM was poorly controlled (Mean HbA1C 9.78±2.83%; RBG 251.83 ± 158.15 mg/dL). The majority of patients had sepsis (68.26%) and renal function impairment (62.72%). Ulcers with Wagner grades of 4–5 were frequent (41.31%). The highest percentage of sepsis (80.49%) and the average leukocyte level (22.60±11.95 x109/L) were found in gangrenous feet. Anemia was more predominant and severe in ulcers with higher Wagner grades. Trauma and Escherichia coli were the most common precipitating factors and microorganisms isolated, respectively. Amputation was performed for 82.36% of patients who were admitted to hospital with gangrene. The Lower Extremity Amputation (LEA) and mortality rates were 14.11% and 40.93%, respectively. Conclusion: DFUs were found to have a relatively high prevalence among T2DM patients, and must never be neglected due to the high associated mortality rate.


2018 ◽  
Vol 12 (1) ◽  
pp. 27-30 ◽  
Author(s):  
Ramya Kateel ◽  
Alfred J. Augustine ◽  
Shivananda Prabhu ◽  
Sheetal Ullal ◽  
Manohar Pai ◽  
...  

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