The validity and reliability of the Diabetic Foot Scale-Short Form (DFS-SF) in the Turkish population: a methodological study.

Background/aim: Diabetic foot ulcers (DFUs) cause decreased quality of life due to prolonged hospital stay, loss of workforce, disabilities, psychological trauma, and increased healthcare costs. This study aims to assess the validity and reliability of the Diabetic Foot Scale-Short Form (DFS-SF) for Turkish-speaking individuals with DFUs. Materials and methods: This was a methodological study conducted with 174 Turkish patients with DFUs from March 2020 to December 2020. Translation-back translation was performed for language equivalence and expert opinions were obtained for content validity. The scale's construct validity was tested with confirmatory factor analysis, exploratory factor analysis, and known-group validity. Cronbach's alpha was used to evaluate internal consistency. Correlation of the DFS-SF with the SF-36 was used to test criterion validity. The scale was then revised according to the TRIPOD checklist. Results: The content validity index value was 0.93 and Cronbach's alpha ranged from 0.93 to 0.97. The scale maintained its six-factor structure and the factor loadings ranged from 0.52 to 0.86. The fit indices of the model revealed good validity. The correlations (r = 0.43-0.76, p < 0.001) and known-group comparisons supported the construct validity. Conclusion: The Turkish version of the DFS-SF is a reliable tool for measuring the quality of life of people suffering from DFUs.

Assessment the effect of diabetes education on self-care behaviors and glycemic control in the Turkey Nursing Diabetes Education Evaluating Project (TURNUDEP): a multi-center study.

BACKGROUND: Diabetes education in Turkey is provided by diabetes nurse educators in almost all healthcare organizations. However, the education is not standardized in terms of learning content, duration, and methods. This multi-center study was performed to assess the self-care behaviors and glycemic control following education provided to the patients with type 2 diabetes mellitus by diabetes nurse educators. METHODS: This was a descriptive and cross-sectional study and included 1535 patients admitted to 28 public hospitals for the treatment of type 2 diabetes mellitus. The education was assessed by using a Patient Identification Form and Self-care Scale. RESULTS: The proportion of individuals who received diabetes education within the last year was 78.5%, with 46.7% of them having received it once. Of the patients, 84.8% reported that they received diabetes education individually. It was found that the proportion of individuals who received education about oral antidiabetics (78.5%) and glucose testing at home (78.5%) was higher than the proportion of individuals who received education about exercise (58.8%) and foot care (61.6%). The status of diabetes education, education intervals, and the correlation of the education method with self-care and glycemic control was evaluated. Self-care and glycemic control levels were better among the patients who received diabetes education thrice or more and in patients who received education both individually and in a group (p < 0.05). CONCLUSIONS: Approximately three-quarters of individuals with type 2 diabetes mellitus received education by diabetes nurse educators in Turkey. Diabetes education is positively correlated with self-care and glycemic control levels among patients with type 2 diabetes mellitus. Efforts for generalization and standardized education for all diabetes patients are necessary.

Low handgrip strength is associated with diabetic foot disease in geriatric patients with type 2 diabetes.

BACKGROUND: This study aims to reveal the prevalence of low handgrip strength in older patients with type 2 diabetes who have diabetic foot disease and to assess the association of handgrip strength with diabetic foot disease in older patients with type 2 diabetes. METHODS: Eighty-nine geriatric patients with diabetic foot ulcers and 69 patients without diabetic foot ulcers who presented to the endocrinology outpatient clinic between August 2020 and November 2021 were included in the study. The exclusion criteria were the usage of steroids, stroke-induced quadriplegia, myopathy, disability, hemodialysis treatment, type 1 diabetes, patients under 65 years of age, and history of malignancy. The information of drugs administered, demographic and clinical data were obtained from the patient files. The Wagner score was used to evaluate the severity of ulcers. A handgrip strength test was performed with a handheld digital dynamometer. For females <16 kg (kilograms), for males <27 kg was accepted as low handgrip strength. RESULTS: Forty-nine patients (55.1%) with diabetic foot ulcers and 25 (36.2%) patients without diabetic foot ulcers had low handgrip strength. There was a significant difference between two groups (p = 0.019). The patients with diabetic foot ulcers who had lower handgrip strength had higher rates of peripheral artery disease than patients with diabetic foot ulcers who had normal handgrip strength (p = 0.02 and p = 0.009, respectively). The patients with diabetic foot ulcers who had lower handgrip strength, had significantly higher rates of Wagner scores 4 and 5 and lower rates of Wagner scores 1 and 3 (p = 0.039). DISCUSSION: Older patients with type 2 diabetes and diabetic foot disease had a higher rate of low handgrip strength. Low handgrip strength was significantly associated with the occurrence of diabetic foot ulcers and directly correlated with Wagner score in geriatric patients with type 2 diabetes.