Effectiveness of Behavioural Change Communication on Knowledge of Self Care Management of Diabetic Foot Ulcer among Diabetes Patients

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.

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Reasons for (non‐)adherence to self‐care in people with a diabetic foot ulcer

Wound Repair and Regeneration ◽

10.1111/wrr.12728 ◽

2019 ◽

Vol 27 (5) ◽

pp. 530-539 ◽

Cited By ~ 3

Author(s):

Jaap J. Netten ◽

Leonard Seng ◽

Peter A. Lazzarini ◽

Jason Warnock ◽

Bernd Ploderer

Keyword(s):

Diabetic Foot ◽

Self Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer

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Does intensive glycaemic control promote healing in diabetic foot ulcers? – a feasibility study

BMJ Open ◽

10.1136/bmjopen-2019-029009 ◽

2020 ◽

Vol 10 (1) ◽

pp. e029009 ◽

Cited By ~ 1

Author(s):

Ajith Dissanayake ◽

Alain C Vandal ◽

Veronica Boyle ◽

Diane Park ◽

Bobbie Milne ◽

...

Keyword(s):

Glycaemic Control ◽

Insulin Therapy ◽

Intensive Insulin Therapy ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Foot Ulcers ◽

Ulcer Area ◽

Diabetes Patients

IntroductionOne in four diabetes patients will develop a foot ulcer over their lifetime. The role of glycaemic control in the healing of foot ulcers in diabetes patients is not supported by randomised controlled trial (RCT) data.ObjectivesTo determine the feasibility of an RCT of glycaemic control with intensive insulin therapy in diabetic foot ulcer, by assessing: entry criteria, fasting capillary blood glucose (FCBG) medication satisfaction and sensitivity of different ulcer-healing endpoints to glycaemic control.DesignTwo substudies: one cross-sectional and one single-arm prospective.SettingSingle-centre secondary care diabetic foot clinic in New Zealand.ParticipantsSubstudy 1: 78 participants consisting of all people ≥18 years with a diabetic foot ulcer presenting to the clinic over 35 weeks in 2015.Substudy 2: 15 participants from Substudy 1 consenting to intensive insulin therapy.InterventionSubstudy 1: None.Substudy 2: Intensive insulin therapy with standard podiatry care over 24 weeks.OutcomeSubstudy 1: Proportion of participants satisfying potential RCT entry criteria; medication satisfaction (Diabetes Medication Satisfaction).Substudy 2: FCBG, index ulcer healing time, index ulcer size, health-related quality of life (HRQoL; EuroQol 5 Dimensions 5 Levels and Diabetic Foot Ulcer Scale-Short Form).ResultsProportion in Substudy 1 satisfying all entry criteria was 31% (95% CI 21 to 42). FCBG values decreased between baseline and study end (difference −3.7 mmol/L, 95% CI −6.5 to −0.8); 83% (95% CI 44 to 95) of ulcers healed by 24 weeks. FCBG correlated negatively with medication satisfaction. Ulcer area logarithm was most sensitive to FCBG changes, displaying significant negative correlation with HRQoL outcomes. Detecting a 30% between-group difference in this outcome (80% power, α=5%) requires 220 participants per arm, achievable within 1 year with 15 centres similar to study setting.ConclusionsAn adequately powered RCT requires cooperation between a large number of centres. Ulcer area logarithm should be primary endpoint.Trial registration numberANZCTR ACTRN12617001414303

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Harnessing Digital Health Technologies to Remotely Manage Diabetic Foot Syndrome: A Narrative Review

Medicina ◽

10.3390/medicina57040377 ◽

2021 ◽

Vol 57 (4) ◽

pp. 377

Author(s):

Bijan Najafi ◽

Ramkinker Mishra

Keyword(s):

Risk Factors ◽

Diabetic Foot ◽

Digital Health ◽

Self Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Health Technologies ◽

Foot Disease

About 422 million people worldwide have diabetes and approximately one-third of them have a major risk factor for diabetic foot ulcers, including poor sensation in their feet from peripheral neuropathy and/or poor perfusion to their feet from peripheral artery disease. The current healthcare ecosystem, which is centered on the treatment of established foot disease, often fails to adequately control key reversible risk factors to prevent diabetic foot ulcers leading to unacceptable high foot disease amputation rate, 40% recurrence of ulcers rate in the first year, and high hospital admissions. Thus, the latest diabetic foot ulcer guidelines emphasize that a paradigm shift in research priority from siloed hospital treatments to innovative integrated community prevention is now critical to address the high diabetic foot ulcer burden. The widespread uptake and acceptance of wearable and digital health technologies provide a means to timely monitor major risk factors associated with diabetic foot ulcer, empower patients in self-care, and effectively deliver the remote monitoring and multi-disciplinary prevention needed for those at-risk people and address the health care access disadvantage that people living in remote areas. This narrative review paper summarizes some of the latest innovations in three specific areas, including technologies supporting triaging high-risk patients, technologies supporting care in place, and technologies empowering self-care. While many of these technologies are still in infancy, we anticipate that in response to the Coronavirus Disease 2019 pandemic and current unmet needs to decentralize care for people with foot disease, we will see a new wave of innovations in the area of digital health, smart wearables, telehealth technologies, and “hospital-at-home” care delivery model. These technologies will be quickly adopted at scale to improve remote management of diabetic foot ulcers, smartly triaging those who need to be seen in outpatient or inpatient clinics, and supporting acute or subacute care at home.

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THE RELATIONSHIP BETWEEN SELF-CARE MANAGEMENT AND DIABETES FOOT ULCER RISK AMONG TYPE 2 DIABETES PATIENTS

Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal ◽

10.32583/pskm.9.1.2019.46-50 ◽

2019 ◽

Vol 9 (1) ◽

pp. 46-50

Author(s):

Hermanto Hermanto ◽

Salustiano Salustiano

Keyword(s):

Type 2 Diabetes ◽

Quantitative Research ◽

Care Management ◽

Self Care ◽

Foot Ulcer ◽

The Body ◽

P Value ◽

Cross Sectional ◽

Diabetes Patients

Diabetes is a disease that leads to death in developing countries including Indonesia. Diabetic Foot Ulcers (DFU) is one of the clinical complications that result from the degenerative changes through the body. The purpose of the study is to examine relationship between degree of self-care management and diabetes foot ulcer risk among type 2 diabetes patients. In this study, the investigator utilized the quantitative research method with correlation design using cross-sectional approach. With the computed value 0.000 lower than p value at 0.05 significant level statistical data analysis revealed a significant relationship between level of self-care management and foot ulcer risk. The level of self-care management has strong influence on foot ulcer risk; better self-care management leads to lower risk of foot ulcer in type 2 diabetes patients.

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The economic burden of inpatient diabetic foot ulcers in Toronto, Canada

Vascular ◽

10.1177/1708538120923420 ◽

2020 ◽

Vol 28 (5) ◽

pp. 520-529

Author(s):

Muzammil H Syed ◽

Konrad Salata ◽

Mohamad A Hussain ◽

Abdelrahman Zamzam ◽

Charles de Mestral ◽

...

Keyword(s):

Internal Medicine ◽

General Internal Medicine ◽

Economic Burden ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

General Internal ◽

Costs Of Care ◽

Mean Cost ◽

Diabetes Patients

Objective Diabetic foot ulcer, which often leads to lower limb amputation, is a devastating complication of diabetes that is a major burden on patients and the healthcare system. The main objective of this study is to determine the economic burden of diabetic foot ulcer-related care. Methods We conducted a multicenter study of all diabetic foot ulcer patients admitted to general internal medicine wards at seven hospitals in the Greater Toronto Area, Canada from 2010 to 2015, using the GEMINI database. We compared the mean costs of care per patient for diabetic foot ulcer-related admissions, admissions for other diabetes-related complications, and admissions for the top five most costly general internal medicine conditions, using the Ontario Case Costing Initiative. Regression models were used to determine adjusted estimates of cost per patient. Propensity-score matched analyses were performed as sensitivity analyses. Results Our study cohort comprised of 557 diabetic foot ulcer patients; 2939 non-diabetic foot ulcer diabetes patients; and 23,656 patients with the top 5 most costly general internal medicine conditions. Diabetic foot ulcer admissions incurred the highest mean cost per patient ($22,754) when compared to admissions with non-diabetic foot ulcer diabetes ($8,350) and the top five most costly conditions ($10,169). Using adjusted linear regression, diabetic foot ulcer admissions demonstrated a 49.6% greater mean cost of care than non-diabetic foot ulcer-related diabetes admissions (95% CI 1.14–1.58), and a 25.6% greater mean cost than the top five most costly conditions (95% CI 1.17–1.34). Propensity-scored matched analyses confirmed these results. Conclusion Diabetic foot ulcer patients incur significantly higher costs of care when compared to admissions with non-diabetic foot ulcer-related diabetes patients, and the top five most costly general internal medicine conditions.

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Enhanced Expression of miR-34c in Peripheral Plasma Associated with Diabetic Foot Ulcer in Type 2 Diabetes Patients

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s326066 ◽

2021 ◽

Vol Volume 14 ◽

pp. 4263-4273

Author(s):

Tingting Wu ◽

Dandan Xie ◽

Xiaotong Zhao ◽

Murong Xu ◽

Li Luo ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Peripheral Plasma ◽

Enhanced Expression ◽

Diabetes Patients

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The Assessment of Social Support and Self-Care Requisites for Preventing Diabetic Foot Ulcer in Diabetic Foot Patients

Journal of Education and Community Health ◽

10.21859/jech-02045 ◽

2017 ◽

Vol 2 (4) ◽

pp. 34-40 ◽

Cited By ~ 3

Author(s):

Mohammad Taher ◽

Hamid Abredari ◽

Mahmood Karimy ◽

Marim Rahmati ◽

Mohammad Atarod ◽

...

Keyword(s):

Social Support ◽

Diabetic Foot ◽

Self Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer

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Quality of Life in Diabetic Foot Ulcer: Associated Factors and the Impact of Anxiety/Depression and Adherence to Self-Care

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734619900415 ◽

2020 ◽

Vol 19 (2) ◽

pp. 165-179 ◽

Cited By ~ 2

Author(s):

Maria Polikandrioti ◽

Georgios Vasilopoulos ◽

Ioannis Koutelekos ◽

Georgios Panoutsopoulos ◽

Georgia Gerogianni ◽

...

Keyword(s):

Diabetic Foot ◽

General Health ◽

Self Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Anxiety And Depression ◽

Diabetic Ulcer ◽

Low Levels ◽

Anxiety Depression ◽

The Impact

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus that needs a multidisciplinary approach. The purpose of this study was to assess the impact of patients’ characteristics, anxiety/depression, and adherence to guidelines on the QoL of patients with diabetic ulcer. The sample of the study consisted of 195 patients. Data collected by the completion of SF-36 Health Survey, the Hospital Anxiety and Depression Scale, and a questionnaire that measured adherence to self-care activities. Patients had moderate- to high-quality levels in emotional well-being, pain, social functioning, and energy/fatigue (median: 68, 68, 63, and 60, respectively), while they had low levels of quality in physical functioning, role physical, and role emotional (median: 21, 0, and 33, respectively). In their general health, patients had moderate levels (median: 50). High levels of anxiety and depression were observed in 13.8% and 20.0% of the participants, respectively. After multiple regression, regarding general QoL, patients living in the capital city had 9.89 points worse general health than patients living in Attica (β = −9.89, 95% confidence interval [CI] = −16.86 to 2.93, P = .006). Patients with moderate or high levels of anxiety had 9.37 and 16.08 points, respectively, worse general health than those with low levels (β = −9.37, 95% CI = −17.04 to 1.70, P = .017, and β = −16.08, 95% CI = −26.65 to −5.51, P = .003, respectively). Clinically, these findings may help health professionals attain effective treatment of emotional burden to DFU patients and increase adherence to self-care.

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Patients’ awareness and extent of self-reported foot care practices in diabetes population

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20193763 ◽

2019 ◽

Vol 5 (9) ◽

pp. 246

Author(s):

Mohammed Assen Seid ◽

Eden Zenebe Worku ◽

Habtamu Bulbula Mideksa

Keyword(s):

Self Care ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Care Practice ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Foot Care ◽

Cross Sectional ◽

Care Practices ◽

Diabetes Patients

Background: Diabetic foot ulcer is a serious complication of diabetes which results lower extremity amputation. Proper preventative measures, appropriate foot self-care and management of foot ulcer will reduce, delay or prevent the incidence of infection, gangrene, and amputation. This study was intended to assess diabetes patients’ awareness and extent of foot care practice at University of Gondar referral Hospital.Methods: An institutional based cross-sectional study was conducted from March to June 2018. A total of 372 diabetes patients were included in this study. Data were collected through face to face interview using structured questionnaires. The data were analyzed using SPSS version 20. Binary logistic regression analysis was conducted. A p value <0.05 was consisdered statitisticaly significant. Results: Of all participants more than half 197 (53%) were male. The age range of participants was 18-90 years. Majority, 65.6 % (with 95% CI 60.8-70.2) of diabetes patients had good foot self-care practice. Poor foot self-care practice was significantly associated with having poor level of awareness about foot care (AOR 12.55, 95% CI, 6.49- 24.28) and having no previous information about foot ulcer (AOR 7.03, 95% CI, 2.11-23.46).Conclusions: Generally, in this hospital most of the study participants had good awareness and practices towards foot self-care. However, selectively majority of patients had poor foot self-care practice regarding; drying of their feet after every wash, change the socks/stockings/ used regularly, and avoid wearing of slippers with no fastening. Foot self-care practices were positively associated with having good awareness about foot care and having previous information about foot ulcer.

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