Gabbay Robert A, Kaul Shailja, Ulbrecht Jan, Scheffler Neil M, Armstrong David G
Penn State Institute for Diabetes and Obesity, Division of Endocrinology, Diabetes, and Metabolism, Penn State College of Medicine, Hershey, PA 17033, USA.
J Am Podiatr Med Assoc. 2011 Jan-Feb;101(1):78-84. doi: 10.7547/1010078.
Foot ulceration and lower-extremity amputation are devastating end-stage complications of diabetes. Despite agreement that diabetic foot self-care is a key factor in prevention of ulcers and amputation, there has only been limited success in influencing these behaviors among patients with diabetes. While most efforts have focused on increasing patient knowledge, knowledge and behavior are poorly correlated. Knowledge is necessary but rarely sufficient for behavior change. A key determinant to adherence to self-care behavior is clinician counseling style. Podiatrists are the ideal providers to engage in a brief behavioral intervention with a patient. Motivational interviewing is a well-accepted, evidence-based teachable approach that enhances self-efficacy and increases intrinsic motivation for change and adherence to treatment. This article summarizes some key strategies that can be employed by podiatrists to improve foot self-care.
足部溃疡和下肢截肢是糖尿病极具破坏性的终末期并发症。尽管人们一致认为糖尿病足自我护理是预防溃疡和截肢的关键因素，但在影响糖尿病患者的这些行为方面，成效有限。虽然大多数努力都集中在增加患者知识上，但知识与行为之间的关联较弱。知识是行为改变的必要条件，但很少是充分条件。坚持自我护理行为的一个关键决定因素是临床医生的咨询方式。足病医生是对患者进行简短行为干预的理想提供者。动机性访谈是一种广被接受、基于证据且可传授的方法，可增强自我效能感，并增加改变和坚持治疗的内在动力。本文总结了足病医生可采用的一些关键策略，以改善足部自我护理。
