scholarly journals Seek, and ye shall find: Efficacy of proactive screeningfor diabetic foot ulceration in the community autonomously performed by nurses

2020 ◽  
Vol 21 (Issue 1 Volume 21, 2020) ◽  
pp. 33-40
Author(s):  
Letizia Pieruzzi ◽  
Elisabetta Iacopi ◽  
Maria Grazia Buccarello ◽  
Ludovica Tamburini ◽  
Chiara Goretti ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Community Setting ◽  
High Morbidity ◽  
Care Model ◽  
Foot Ulceration ◽  
Financial Costs

Diabetic foot ulceration (DFU) is a severe complication of diabetes mellitus associated with a high morbidity and mortality rate, whose treatment requires considerable financial costs. This paper describes a test of the efficacy of proactive screening – autonomously managed by nurses in a community setting – in detecting patients at high risk of DFU, as an integrated part of a chronic care model strategy.

Efficacy of Fifth Metatarsal Head Resection for Treatment of Chronic Diabetic Foot Ulceration

2005 ◽  
Vol 95 (4) ◽  
pp. 353-356 ◽  
Author(s):  
David G. Armstrong ◽  
Mark A. Rosales ◽  
Agim Gashi
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Conservative Treatment ◽  
Diabetic Foot ◽  
Retrospective Cohort ◽  
Potential Benefit ◽  
Metatarsal Head ◽  
Cohort Model ◽  
Foot Ulceration ◽  
Surgical Group

This study compares the potential benefit of fifth metatarsal head resection versus standard conservative treatment of plantar ulcerations in people with diabetes mellitus. Using a retrospective cohort model, we abstracted data from 40 patients (22 cases and 18 controls) treated for uninfected, nonischemic diabetic foot wounds beneath the fifth metatarsal head. There were no significant differences in sex, age, duration of diabetes mellitus, or degree of glucose control between cases and controls. Patients who underwent a fifth metatarsal head resection healed significantly faster (mean ± SD, 5.8 ± 2.9 versus 8.7 ± 4.3 weeks). Patients were much less likely to reulcerate during the period of evaluation in the surgical group (4.5% versus 27.8%). The results of this study suggest that fifth metatarsal head resection is a potentially effective treatment in patients at high risk of ulceration and reulceration. (J Am Podiatr Med Assoc 95(4): 353–356, 2005)

scholarly journals Assessment of the quality of primary care for the elderly according to the Chronic Care Model

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Líliam Barbosa Silva ◽  
Sônia Maria Soares ◽  
Patrícia Aparecida Barbosa Silva ◽  
Joseph Fabiano Guimarães Santos ◽  
Lívia Carvalho Viana Miranda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Older People ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Statistical Difference ◽  
Care Model ◽  
Care Outcomes

ABSTRACT Objective: to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. Method: cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life. Data analysis was based on descriptive statistics and multiple logistic regression. Results: there was a predominance of females and a median age of 72 years. The median PACIC score was 1.55 (IQ 1.30-2.20). Among the PACIC dimensions, the “delivery system design/decision support” was the one that presented the best result. There was no statistical difference between the medians of the overall PACIC score and individual care outcomes. However, when the quality of life and health satisfaction were simultaneously evaluated, a statistical difference between the medians was observed. Conclusion: the low PACIC scores found indicate that chronic care according to the CCM in the PHC seems still to fall short of its assumptions.

Vernetzte Betreuung von Patientinnen und Patienten mit Herzinsuffizienz

2011 ◽  
Vol 68 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Cornelia Bläuer ◽  
Otmar Pfister ◽  
Christa Bächtold ◽  
Therese Junker ◽  
Rebecca Spirig
Keyword(s):  
Chronic Care Model ◽  
Chronic Care ◽  
Care Model

Patienten mit Herzinsuffizienz (HI) sind in ihrer Lebensqualität stark eingeschränkt, haben eine schlechte Prognose und müssen häufig hospitalisiert werden. Die Forschung hat gezeigt, dass die Gesundheitsresultate dieser Patientengruppe durch ein gutes Selbstmanagement verbessert werden können. Eine Möglichkeit zur Verbesserung des Selbstmanagements sind ambulante Diseasemangementprogramme, welche die Lebensqualität verbessern und Kosten reduzieren helfen. Solchen Programmen liegt meist das von der WHO entwickelte Chronic Care Model zu Grunde, welches auf die Betreuung chronisch Kranker mit einem hohen Selbstmanagementbedarf ausgerichtet ist. Um ein gutes Selbstmanagement entwickeln zu können braucht es bedürfnissorientierte Patientenschulung und -beratung, denn die Betroffenen benötigen nicht nur Wissen zur Krankheit sondern müssen handlungsfähig werden. In der Schweiz fehlt es an etablierten Modellen und Programmen zur Betreuung von chronisch Kranken, insbesondere HI-Betroffenen. Aus diesem Grund hat eine schweizerische Expertengruppe für HI eine Modell zur „vernetzten Betreuung“ erstellt. In Anlehnung daran bietet die Schweizerische Herzstiftung seit 2009 ein Schulungsprogramm zur Unterstützung von Ärzten, Betroffenen und deren Angehörige an. Eine erste Evaluation hat unterschiedliche Resultate von Seiten der Ärzte gezeigt. Von den Betroffenen waren die Rückmeldungen äußerst positiv. Sie beurteilten die Schulungen als bedürfnissorientiert und unterstützend. (Geschlechtsbestimmende Begriffe stehen immer stellvertretend für beide Geschlechter)

scholarly journals Diabetic Foot Care Plan

2000 ◽  
Vol 11 (suppl d) ◽  
pp. 15D-21D
Author(s):  
Gordon Dow ◽  
The Diabetic Foot Care Plan Working Group
Keyword(s):  
Diabetes Mellitus ◽  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Economic Loss ◽  
Care Plan ◽  
Foot Care ◽  
Foot Ulceration ◽  
General Management ◽  
Clinical Scenarios ◽  
Therapeutic Guidelines

Diabetes mellitus is the number one cause of limb loss in North America, and is associated with growing, unacceptable rates of morbidity, mortality and economic loss. Approximately 80% of these amputations are preceded by the development of foot ulceration. Various disciplines have studied the prevention and management of foot ulceration in those with diabetes. The present care plan was constructed to incorporate the important contributions from these disciplines into practical therapeutic guidelines. The care plan has been divided into three basic sections: assessment, general management and antibiotic therapy. Each of these sections is described in detail and borrows heavily from previous Canadian position papers. Application of the care plan is illustrated by multiple diabetic foot clinical scenarios, which have been categorized according to the Wagner classification.

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