Cuaderes Elena, Khan Myrna M, Azzarello Joseph, Lamb W Lyndon
University of Oklahoma Health Sciences Center, College of Nursing, Oklahoma City, OK 73117, USA.
J Nurs Meas. 2009;17(1):3-18. doi: 10.1891/1061-3749.17.1.3.
Neuropathy with excessive weight-bearing activity may lead to foot changes that place it at risk for ulceration. Information about instruments to measure plantar skin hardness and pressures of the foot in adult Native Americans with diabetes is presented. Skin hardness was measured at 10 sites (plantar side of the hallux, third and fifth toes, first, third, and fifth metatarsal heads, medial and lateral midfoot, heel, and the dorsal aspect between the hallux and second toe) with a durometer. The PressureStat yielded data about barefoot, static pressures. The durometer was shown to be reliable (r = .62 to .91) at all sites of the foot except at the third and fifth toe, the medial midsection of both feet, and at the third metatarsal head and between the hallux and second toe, the dorsal aspect of the left foot. With four raters, concordance was found to be acceptable at the hallux, the third toe, the first, third, and fifth metatarsal heads and the heel (W = .61 to .86) for the PressureStat. Since most diabetic foot ulcers occur at the hallux, first, third, and fifth metatarsal heads, both the PressureStat and durometer may be reliable screening tools to determine the degree of risk.
负重活动过多导致的神经病变可能会引起足部变化，使其面临溃疡风险。本文介绍了用于测量成年美国原住民糖尿病患者足底皮肤硬度和足部压力的工具。使用硬度计在10个部位（拇趾、第三和第五趾的足底侧，第一、第三和第五跖骨头，足内侧和外侧中部，足跟，以及拇趾和第二趾之间的背侧）测量皮肤硬度。压力测量仪可获取赤脚静态压力数据。除了第三和第五趾、双脚内侧中部、第三跖骨头以及拇趾和第二趾之间（左脚背侧），硬度计在足部所有部位都显示出可靠性（r = 0.62至0.91）。对于压力测量仪，在四名评估者的情况下，拇趾、第三趾、第一、第三和第五跖骨头以及足跟处的一致性被认为是可接受的（W = 0.61至0.86）。由于大多数糖尿病足溃疡发生在拇趾、第一、第三和第五跖骨头处，压力测量仪和硬度计都可能是确定风险程度的可靠筛查工具。
