Abstract
BackgroundThe aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance).Results60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score ≤5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%.Conclusionthe planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.
Highlights
The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear
The presence of foot ulcerations in diabetic individuals at risk for complications is a frequent event, with an estimated 15% of all diabetic individuals experiencing an episode of ulceration at some point during their life
Several factors are involved in the development of this process which include Peripheral Neuropathy (PN), Peripheral Vascular Disease (PVD), limited joint mobility and repeated trauma from abnormal load distribution on the foot [1,2]
Summary
The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. Several factors are involved in the development of this process which include Peripheral Neuropathy (PN), Peripheral Vascular Disease (PVD), limited joint mobility and repeated trauma from abnormal load distribution on the foot [1,2] This unfavorable progression can be modified provided effective preventive measures are adopted such as adequate guidance regarding: 1- lack of sensitivity and/or presence of peripheral vascular disease and its implications, 2- hygiene and moisturizing practices, 3- use of adequate footwear (when indicated), 4mandatory daily self-care (self-examination). Preventive and care practices should provide guidance on the correct way to wash, dry and moisturize the feet as well as on how to cut nails and not trim cuticles, or use pumice stones and similar abrasive objects, use appropriate footwear, perform regular foot and footwear inspection and never walk barefoot [3,4,5]
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