The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: A case report.

Abstract

Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers.Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit.Results: Significant changes were reported in diabetes selfmanagement practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5.62 to 8.,54 and the Summary of Diabetes Self- Care Activities (SDSCA) score increased from 3.2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks.Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education.Significance for public healthDiabetes mellitus (DM) with diabetic foot ulcer significantly contributes to the deterioration in health and financial burden on the patient. The increased risk of diabetic foot ulcers, especially in elderly patients with inadequate glycemic control tends to increase diabetes complications and mortality. Furthermore, the functional impairment, cognitive dysfunction, and poverty caused by the aging process make it difficult for elderly people to access health services. Home-based interventions carried out by community health nurses using the patient-centered care approach have advantages in improving access to services. Focusing on the self-management with Diabetes Self-Management Education (DSME) and wound care management to improve glycemic control, optimize the healing process, and also improve health promotion to prevent recurrent diabetic foot ulcers. This article provides an overview on the effectiveness of home-based nursing intervention in the elderly patients with recurrent diabetic foot ulcers.