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@#Introduction: Diabetes is a chronic illness and it has a significant impact on health. Behavioral interventions theory could improve self-care practices of the foot among patients with diabetic. Behavioral interventions could prevent the risk of foot problems. This trial aims at determining the effect of patient education intervention on foot self-care behavior and clinical outcomes among diabetes patients. Methods: The study is a two-arm single-blinded randomized controlled trial which will be conducted in the Federal Medical Centre (FMC) Owerri, Imo state, Nigeria involving 160 diabetic patients. A central computer-generated randomization list will be generated. Sequentially numbered sealed opaque envelopes will be used to determine concealment. The sample size is 160; therefore 80 participants will receive three sessions of patient education in addition to usual care (intervention group) for three and six months while another 80 participants (control group) will receive only usual care and will receive health education after the study is completed. The outcome of the intervention effectiveness is measured by modified version of Diabetes foot Self-Care Behavior Scale (DFSBS). Discussion: Our hypothesis is that based on the Health Belief Model, patient education intervention can improve foot self-care behavior in the intervention group. Data collection will be done at baseline, and at three- and six-months post intervention. Trial Registration: The Clinical Trials Registry- India (CTRI), Reference no CTRI/2021/06/034311.
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@#Introduction: Diabetic foot ulcers (DFUs) remain one of the greatest significant problems of diabetes mellitus. It is a cause of main suffering and expenses for patient, and financial problem on health facilities and public. One of the strategies to overcome DFU is through health education to prevent foot ulcer, which focused in promoting foot self-care. To reach this aim, researchers had applied different educational approaches. This systematic review is to evaluate various types of educational programs in terms of its method of delivery and effectiveness. Methods: The search involved various databases; EBSCOHOST, MEDLINE, CINAHL, Cochrane library, ScienceDirect, PubMed, SAGE SringerLink, Web of Science and Wiley Online Library. It was limited to full text research articles that report intervention studies, and the writte up in English Language, the publication was from 2005 to 2021. The key words were “diabetes”, “diabetes foot”, “foot self-care”, health education and “interventions”. Results: Twenty studies were involved in this review. Nine studies were randomized controlled trials (RCTs), while eleven reported non-randomized controlled trials (NRCTs). Conclusion: There are evidences that foot care education improves foot care and diabetic foot problems. Various health education approaches, for instance foot assessment, discussion, counseling, homebased visitation and telephone calls have been shown to be effective in improving educational programs. Studies in the future should focus on RCTs in different sites and apply follow-up of long duration to provide better recommendations to healthcare practitioners on effective educational interventions to prevent DFUs.
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@#Introduction: Diabetic foot infection, a complication which can lead to lower limb amputation, is a major source of morbidity and mortality in Malaysia. The objective of this study was to determine the predictive factors of major lower limb amputation among patients with diabetes mellitus in a cluster of three district hospitals in Pahang, Malaysia. Materials and Methods: This cross-sectional study involved 170 patients who had undergone surgical interventions for diabetic foot infections at three district hospitals from 1st of September 2014 to 31st December 2015. The predictors for major amputation of lower limb were determined using simple logistic regression (LR) and forward LR multiple logistic regression. Results: A total of 21 patients had undergone major amputations of lower limb (15 transtibial and 6 transfemoral). The following factors were associated with major amputation of lower limb; longer duration of disease, age ≥ 60 years, patients from Bentong Hospital, presence of hypertension, presence of fever, history of multiple limbsalvaging surgeries, monomicrobial culture, necrotising fasciitis, anemia and leukocytosis. Upon forward LR multiple logistic regression, only duration of disease, history of more than three previous limb-salvaging surgeries and total white blood cell count ≥15X109/L were found to be significant as predictive factors of major amputation of lower limb. Conclusion: Among the factors analysed in this study, a longer duration of disease, raised total white blood cell count and history of more than three limb-salvaging surgeries were identified as predictors for major amputation of lower limb in diabetic foot infections using stepwise logistic regression analysis.
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Objective To explore the prevalence of depression in diabetes foot ulcer patients , and to an-alyze the correlation between depression morbidity and various factors such as age , HbA1c level, and quality of life etc.Methods 73 diabetes foot ulcer patients admitted from Sep .2012 to Sep.2014 were enrolled.Depres-sion was assessed using the 9-item patient health questionnaire (PHQ-9).Data such as the age, sex, duration of diabetes and foot ulcer , HbA1C level, smoking were recorded .The severity of foot ulcer was evaluated by Wagner's classification.The quality of life was scored by short form(SF-36)health survey questionnaire.Results The morbidity of depression in diabetes foot ulcer patients was 49.3%in total and 17.8% in the moderate to severe depression group .The prevalence in patients with HbA 1c≥7.0%was significantly higher than that in pa-tients with HbA1c0.05).Conclusions This study shows a high prevalence of depression symptom in diabetes foot ulcer pa -tients.Depression is associated with HbA1c level, the extent and duration of foot ulcer .