Foot Care In Patients Research Articles

Foot care for patients with rheumatoid arthritis by nurses using a multidisciplinary team approach

Foot care for patients with rheumatoid arthritis by nurses using a multidisciplinary team approach

Pengetahuan Berpengaruh Terhadap Kepatuhan Dalam Perawatan Kaki Pada Klien Diabetes Melitus Tipe II

Background: An increasing number of people with diabetes mellitus will increase the risk of chronic complications, one of which is neuropathy. Diabetic neuropathy can cause disability and even death. Management of Diabetes Mellitus is intended to prevent the occurrence of complications by educating clients about foot care. it aims to improve the knowledge and adherence of people with diabetes mellitus. The purpose of this study was to determine the relationship of the knowledge level of foot care with adherence in performing foot care in patients with Type II Diabetes Mellitus. Research Methods. this study was quantitative research using descriptive-analytic method through a cross-sectional study approach. Data analysis used Chi-Square. This research questionnaire used Nottingham Assessment of Functional Footcare (NAFF) to measure knowledge Rnd Diabetic Foot Care Behavior (DFCB) to measure compliance. Results showed a significant relationship between the level of knowledge with patient compliance in performing foot care (p = 0.001). Conclusion, Based on these results can be concluded that people with diabetes mellitus who have good knowledge will tend to increase adherence in performing foot care.

POINT: podiatry for international diabetic foot teams

The Point Project is an initiative between the two organisations: D-Foot International and the International Federation of Podiatrists (FIP-IFP). Both organisations promote the role of evidence-based foot care for patients with and at risk of diabetes. This collaborative work highlights the podiatric skills needed in order to deliver comprehensive evidence-based care to patients with diabetic foot disease. The statements along with the relevant skills and behaviours are based upon the guidance documents produced by the International Working Group on the Diabetic Foot (IWGDF), thus meaning while this is a consensus document it is also evidence-based. Representatives from both organisations with a multidisciplinary membership met early in 2017 to discuss the different areas of practice and to define which skills and behaviours were required at different levels of practice. Using the TRIEpodD-document (UK) and IWGDF guidance as the basis for discussion, the team identified which knowledge, skills and behaviours could be considered podiatric in nature. Once identified as podiatric, we discussed at which level of podiatric practice they could apply. The members of the team came from a variety of locations which represented practice at the different levels. Following the initial meeting, further discussions took place via email in order to consolidate initial discussions and complete the document. Cognisant of the large volume of guidance in relation to all areas of practice, this document is aimed to assist clinicians by pointing them in the direction in which they need to develop services rather than being a set of rules which must be followed. The POINT team feels that this document supports clinicians globally on three levels: As a benchmarking tool for existing teams to critically reflect upon their practice and identify where quality improvements can be made As a tool for clinicians who wish to establish a diabetic foot team to highlight the skills needed in order to provide care across the breadth of diabetic foot practice highlighting the specific roles in which podiatrists can help For national and local decision makers, to identify which skills can be provided by podiatrists to promote the development of the profession. While this is a consensus relating to podiatric skills, the team is aware that, in the absence of podiatrists, skills will be provided by other health professionals. We support this practice and while such professionals can not be considered podiatrists, they are providing podiatric skills to the diabetic foot team. The delivery of the relevant skill to the patient is the important factor, not the health professional is delivering it. The development of this document is merely the first step to identifying areas where skills need to be developed. Both D-Foot and FIP-IFP are committed to developing podiatric skills further across the globe. The aims and objectives of the two organisations are mutually beneficial to those suffering from diabetic foot disease. People with diabetes deserve the best care that they can receive, irrespective of the resources available. By working together we have been able to identify the podiatric knowledge, skills and behaviours required to provide evidence-based care. The next step is to work together to ensure consistent delivery of these globally for the benefit of those suffering the debilitating consequences of diabetic foot disease.

Barriers to foot care in patients with diabetes as identified by healthcare professionals.

To seek the views of healthcare professionals as to the barriers to foot care that they perceive as having an impact on clinical outcomes and contributing to the number of amputations. The study involved healthcare professionals from the UK attending our 2015 and 2016 Masterclass diabetic foot conferences. Admission to these conferences was open to all members of the multidisciplinary spectrum who provide care of people with diabetes and foot problems. Attendees were asked to write down concerns that they considered to constitute barriers to foot care for people with diabetes. A total of 425 responses were received (90.8% of the total attendance at the 2015/2016 conferences). Analysis of the responses produced eight key subject areas in which barriers to care were identified: patient referrals, communication between disciplines, access to specialist services, patient care, funding, organization of care, education and infection. Within these key areas, respondents reported poor recognition and diagnosis of foot problems, lack of awareness of the need for referral both by the person with diabetes and healthcare professionals, difficulties in the referral pathway, lack of access to multidisciplinary care, shortage of resources and lack of education of both people with diabetes and healthcare professionals. The respondents identified these barriers as contributing to delay in people with diabetes receiving specialist help. Such a delay can lead to amputation. The crucial barrier to diabetic foot care is delay in accessing specialist care. Until this is addressed, care will be less than optimum and amputations will continue.

Foot Care for Patients to Maintain Walking by Nurses

Foot Care for Patients to Maintain Walking by Nurses

Clinicopathological study of diabetic foot in Bundelkhand area with special reference to fungal infection in asymptomatic feet of diabetic patients

Background: As with substantial increasing in incidence of diabetes mellitus in present century and with huge prevalence in population; the incidence of one of the dreadful complication of diabetes i.e. diabetic foot also increases, leading to increase morbidity and mortality. Fungal infection in foot is one of the underweighted cause of foot ulceration. These microulceration in conjunction with diabetes may leads to fulminant infection. The study comprised of 66 cases out of which 16 served as control. Aim and objectives of our study is to study the incidence of fungal infection in asymptomatic feet of diabetic patients, identification of the type of fungus, comparison with nondiabetics and clinicopathological study of the patients.Methods: The present study was carried at Department of Surgery, MLB. Medical College, Jhansi, the study group was classified into two groups. Control group; this group comprised of non-diabetic patients with foot lesions. Disease group; diabetic patients with foot lesions. Webs scrapings were inoculated in Sabouraud’s media slopes. Cultured media were examined after 3 days for the growth. Identification depends on colonial appearance and the morphology of the spores and by Gram, s and AFB Staining.Results: By this study we conclude that fungal infection in asymptomatic foot of diabetes patient are significantly more than non-diabetic patients which is accentuated by duration, type, glycaemic control and practice of bare foot walking which makes diabetic patient more prone for diabetic foot. So, the foot care of patients of diabetes should include the prophylactic steps to prevent fungal growth.Conclusions: By above study, we reasonably conclude that fungal infection in diabetic patients plays a pivotal role in formation of diabetic foot disease, so by eradication of fungal infection in asymptomatic foot of diabetic patient by general preventive methods and/or pharmacological methods may be beneficial in reducing morbidity and mortality in diabetic foot patients.

Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center

Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center

Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center.

ObjectiveThe objective of this study is to measure the level of knowledge and practice of diabetic foot self-care and determine the factors that affect the level and knowledge and practice of diabetic foot self-care among among patients with diabetes..MethodologyThree hundred thirty adult patients with diabetes at the outpatient clinics were given self-administered questionnaires on knowledge and practice of diabetic foot self-care. The scores were computed based on their answers. A score of >70% was gauged as good, 50 to 70% as satisfactory and <50% as poor.ResultsOf the subjects, 82.7% had good foot care knowledge, 22.4% had good foot self-care practice, and 71% had satisfactory practice score. Patients who received diabetes education were twice as likely to have a good knowledge score (OR 2.41, 95% CI, 1.09 to 5.32; p=0.03). Compared to patients who received diabetes care in private clinics, those who attended the charity outpatient clinic were nearly three times as likely to have a good knowledge score (OR 2.8, 95% CI, 1.32 to 5.96; p=0.007). Patients with known diabetes for more than ten years and those with a family history of diabetes were 50% less likely to have good practice scores (OR 0.50, 95% CI, 0.28 to 0.90; p=0.021 and OR 0.49, 95% CI, 0.29 to 0.83; p=0.008, respectively).ConclusionThe current state of foot care knowledge in Filipino respondents with diabetes is good but the level of foot self-care practice is only satisfactory.

The experience of foot problems and decisions to access foot care in patients with rheumatoid arthritis: a qualitative study

BackgroundAlthough foot problems are common in rheumatoid arthritis (RA), the consequences of foot problems from the patient perspective have not been fully explored. The aims of this study were to explore the experience of foot problems and decisions to access foot care services or not in patients with RA.MethodsSemi structured, one-to-one interviews with patients recruited from 2 UK rheumatology units, purposively sampled for self-reported foot problems and a range of personal/disease characteristics. Inductive thematic analysis was used, with rigour provided by multiple independent analysers. Emerging themes were discussed and agreed by all authors.ResultsTwelve patients participated: 7 female; mean age 56 years (29–72); mean disease duration 12 years (2–27), 5 had accessed foot care services. The ‘Impact’ of foot problems was substantial and formed the underpinning theme, comprising three organising themes: ‘Foot symptoms’; ‘Consequences’; and ‘Cost’. Foot symptoms such as pain and numbness required self-management, and affected daily life (walking, working) leading to social and emotional costs. The global theme, ‘Decision to access foot care or not’, also comprised three organising themes: ‘Access perceived unnecessary’ (no problem, can cope); ‘Access hindered by patients’ perception’; and ‘Access supported by patient and clinician’. Decisions to access foot care or not were complex and influenced by patient beliefs regarding possible treatments and how to access these, and hindered by patient perceptions that their feet were ignored by rheumatology clinicians. Positive experience of foot care encouraged continued utilisation but negative experiences contributed to patients’ decisions to discontinue foot care services.ConclusionsFoot problems are important issues for patients and impact on many aspects of their physical, social and emotional lives. Patients who had accessed foot care services prioritised their foot problems as an important health care need. However, for others who would like foot care services, personal knowledge and values, and perceived barriers in clinical practice, appear to interact to inhibit foot care access. The extent which these interactions affect overall access to foot care in RA patients in general now needs to be quantified to help to inform and improve the effectiveness of the organisation and delivery of foot care.

Knowledge, attitude, and practice of foot care in patients with diabetes at central rural India.

Introduction:Diabetic foot syndrome is one of the common and most devastating preventable complications of diabetes mellitus (DM). It is associated with morbidity and premature mortality due to long-term complications affecting foot. The American Diabetes Association recommends that people with diabetes should have a comprehensive foot examination once per year. Most of the foot problems can be prevented with careful foot care. It may take effort and time to build up good foot care habits, but self-care is essential.Aim:The main aim of the study is to analyze the knowledge, attitude, and practice of foot care in patients with DM in central rural India.Methodology:This study was conducted at a rural educational hospital in central part of India over 200 patients who have Type 1 and Type 2 diabetes. They were evaluated for their knowledge about foot care and footwear practices. A structured and validated questionnaire was administered to cases.Results:Around 82.9% of the patients were aware of the disease and 23.2% were aware of the complications of the DM. In 63% of the patients, foot care examination and education regarding foot complications were not suggested by their treating physicians. Annual examination of feet by the physician and self-examination were not known facts to the diabetic population.Conclusion:It is necessary to firstly develop awareness of diabetes mellitus and the related complications, one amongst which is foot care. Certain educational strategies should be established for both the consultant physician and also the common man to create awareness for effective foot care.

Care of Patients with Diabetic Foot Disease in Oman

Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002-2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman.

Comparison of mortality rates and functional results after transtibial and transfemoral amputations due to diabetes in elderly patients-a retrospective study

IntroductionThis study aimed to compare mortality rates and functional results of transtibial and transfemoral amputations in elderly patients with diabetes. Methods87 amputees [54 (62.1%) transtibial and 33 (37.9%) transfemoral] were included. Mean ages were 70.7 and 69.3 years in transfemoral and transtibial groups, respectively. Mean follow up time was 41.8 months. Amputee Mobility Predictor scores (with and without prosthesis) and Barthel Daily Living Index were used for functional evaluation of the survivors. ResultsFirst year mortality rates were 29.6% and 30.3% in transtibial and transfemoral groups, respectively. Overall mortality rate of both groups was 65.5% (66.7% in transtibial and 63.6% in transfemoral group). There was no difference between mortality rates of two groups. Duration between surgery and death was significantly shorter in transfemoral group. The mean Amputee Mobility Predictor scores (with prosthesis) of the transtibial and transfemoral groups were 32.3 and 26.9 points, respectively. The average Amputee Mobility Predictor scores (without prosthesis) of the transtibial and transfemoral groups were 29.5 and 22.7 points respectively. The differences between two groups' scores were significant. The mean Barthel Daily Living Index scores of the transtibial and transfemoral groups were 82.5 and 80.2 points respectively. The difference was not significant. ConclusionsHigh mortality rates and morbidities after major lower limb amputations emphasize the importance of preventive measures and foot care in patients with diabetes.

Improving foot care for patients with diabetes on haemodialysis

Patients on haemodialysis have an increased risk of developing diabetic foot problems, as well as difficulties in accessing specialist care. This service evaluation assessed whether educating haemodialysis nurses in foot care resulted in more frequent examination. It also considered whether improvements in patients' self-care behaviour associated with their feet were reported.

Questionnaire-Based Survey on Foot Care in Patients With Diabetes: A Survey of the Japan Diabetes Society-Certified Educational and Related Educational Facilities

Questionnaire-Based Survey on Foot Care in Patients With Diabetes: A Survey of the Japan Diabetes Society-Certified Educational and Related Educational Facilities

Efficacy of an Intervention Based on the Theory of Planned Behavior on Foot Care Performance in Type II Diabetic Patients

Background: It is known that health education on foot care is a common strategy for preventing diabetic foot and reducing the rate of lower limb amputation. Objectives: To evaluate the efficacy of an intervention based on the theory of planned behavior for improving foot care in patients with type II diabetes in 2013 in Ahvaz, Iran. Patients and Methods: In this clinical trial, 69 patients (30 - 60 years old) who were referred to Golestan Hospital Diabetes Clinic between June and May 2013 were selected randomly and divided into 2 groups (intervention and control). The control group received the clinic’s routine training. In contrast, a 4-week educational program based on the theory of planned behavior was held for the intervention group. Data were collected before and after the intervention using a questionnaire developed for this study that assessed components of the theory of planned behavior, and foot care. Data were analyzed with SPSS version 19 using paired and independent t-tests and chi-squared. Results: The two groups showed no significant difference in terms of demographics or in the mean scores of other variables before the intervention (P > 0.05). After the intervention, a significant increase was observed in the mean scores of attitudes, and foot care performance in the intervention group, and the intervention group had higher scores than did the control group (P < 0.05). Conclusions: An intervention based on the theory of planned behavior was effective in improving the foot care in diabetic patients.

Effect of Educational Programs on the Knowledge, Attitude, and Practice of Foot Care in Patients With Diabetes

Background: Among the complications of diabetes, foot problems are increasing due to nonconformity of preventive issues. Objectives: The current study aimed to evaluate the effect of an educational intervention on knowledge, attitude and practice of foot care among the patients with type 2 diabetes. Patients and Methods: In this randomized controlled clinical trial, 69 patients aged 30-60 years who were referred to an Iranian diabetes clinic were randomly selected and divided into two groups, intervention and control. The control group just received the routine training of the center. A three week educational program was held for the intervention group. Data were collected before and after the intervention by a researcher-made questionnaire and analyzed with SPSS version 19 to apply dependent and independent t-tests and chi-square test. Results: There was insignificant difference between the two groups in terms of demographic variables and the mean scores of other assessed variables before the intervention (p > 0.05). After the intervention a significant increase was observed in the mean scores of knowledge, attitudes, and foot care practice of the intervention group compared to those of the control group (p < 0.05). Conclusions: The educational program was effective on the foot care performance of the patients with diabetes.

The importance of education in diabetic foot care of patients with diabetic neuropathy.

Our aim is to research the effect of the knowledge and routine gained from the diabetic foot (DF) care education program given to patients with Type 2 Diabetes Mellitus (DM) with diabetic neuropathy. A total of 104 patients with Type 2 DM and diabetic neuropathy participated in a survey to evaluate standards of DF care, and knowledge of and behavior relating to personal care. The difference in knowledge and personal care between the group who had received education on diabetes and the group who had not was researched. A total of 42.3% of patients reported receiving education about diabetes. The education for Type 2 DM patients increased the frequency of attending yearly check-ups (p:0.028), and helped develop the habit of having doctors check their feet (p:0.004). When comparing the daily practice of those who had received education about DF care with those who had not, positive effects of education were seen in all questions evaluating foot care, nail care and choice of shoe. The statistical analysis proved that the educated group were significantly better in terms of foot care such as using moisturizer (p:0.002) and using insoles (p:0.042). Our study reveal that educating diabetic patients about foot care is an effective method to develop their knowledge. However we observed that this education is not provided to all diabetic patients. We believe that every diabetic patient should receive education from the moment of diagnosis and repeated education during check-ups by doctors will increase effectiveness.

Evaluación de los autocuidados del pie en pacientes diabéticos. Análisis retrospectivo (2008-2013)

Purpose: The purpose of this study is to analyze other studies and research on foot self care and self-examination in patients with diabetes, taken from different sources of the scientific literature. Methods: The authors carried out a systematic review of published studies (including clinical trials, meta-analysis and Cochrane reviews), about the evaluation of health habits and health education concerning foot care in patients with diabetes. The authors researched articles using the terms “diabetic foot self-care, diabetic foot self-management, diabetes self-care and diabetes selfmanagement” in the Medline, Web of Science, Cochrane Database, CINAHL, Scopus and EMBASE databases. Only 33 of the studies found here and published between January 1990 and May 2012 fulfilled the requirements, as they dealt with medical procedures to reduce the complications in feet caused by diabetes. Results: Of a total of 479 studies identified, the authors previously selected 50, of which 34 were from Pubmed, 12 from Web of Knowledge and four from Cochrane. In the end, they only chose 33 in order to develop this research, of which three were on metaanalysis, four were systematic reviews, six were randomized clinical trials, three were observational studies and 17 were review articles. Conclusions: All the analyzed studies present strategies directed towards a change in behavior. These strategies are effective regarding the metabolic control of the illness and the reduction of amputations. But it is necessary to validate a reliable tool to determine the development of healthy habits and to guarantee their continued practice, given that most studies present a lack of methodology regarding sample selection and time of study.

Factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise health education program

Purpose: To identify factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise program. Methods: The subjects were 21 patients with Type 2 diabetes mellitus (8 males, 13 females). The mean age of the patients was 62.3 ± 12.5 years old. Foot status, physical measurements and daily activities were monitored and several surveys were performed. Results: Changes in foot status were significantly positively correlated with walking at normal speed (r = 0.54, p p p p p

Morphological Pattern Classification System for Plantar Thermography of Patients with Diabetes

A plantar temperature distribution can be obtained by thermography; however, the advantage has not been effectively utilized in the past. We previously proposed a classification method based on the angiosome concept, but the method was insufficient because it was too subjective and complicated for clinicians. In this study, we propose a new classification system of plantar forepart thermographic patterns using an image segmentation technique. A cross-sectional observational study was conducted including 32 healthy volunteers and 129 patients with diabetes mellitus (DM). Individual thermographic variations and trends were evaluated. A comparison was conducted between the patterns obtained by our previous angiosome-based research and the patterns found by the new classification system. The system objectively found wider variations of the plantar forepart thermographic patterns in the patients with DM compared with those in the control subjects. In patients with DM, the system showed that the whole-high pattern was most frequent (46%), followed by the butterfly pattern (12%). In the control group, the butterfly pattern was most frequent (44%), followed by the whole-high pattern (19%). Both ankle and toe brachial indices were higher in feet with high temperature area in the inner side of the plantar. Thermographic patterns found by the new computer-based system were similar to those obtained in our previous subjective work. The classification system found forefoot-low pattern and tiptoe-low pattern objectively. The system based on infrared thermography will be a screening tool to assess circulatory status in daily foot care of patients with DM.