Diabetes Care Unit, Division of Nursing, Osaka University Medical Hospital, Japan.
J Adv Nurs. 2011 Sep;67(9):1952-62. doi: 10.1111/j.1365-2648.2011.05640.x. Epub 2011 Apr 11.
The aim of this study was to assess the effectiveness of a preventative foot care nursing programme for diabetic patients.
Foot complications are common in diabetic patients and prevention of such complications requires foot care. However, there is little information on the effectiveness of foot care nursing on the incidence and recurrence of diabetic foot.
We developed a diabetic foot care programme based on the International Working Group on the Diabetic Foot. We studied 88 patients who attended our foot care programme for 2 years, and collected data from April 2005 to March 2009. Patients were divided into four groups according to the risk classification, and received foot care. We evaluated the incidence of foot ulceration or recurrence and non-ulcerated foot condition. Characteristics of the patients were analysed using the paired t-test and McNemar's test, and changes in severity of tinea pedis and grade of callus were analysed using Wilcoxon's signed rank sum test.
The programme reduced the severity score of tinea pedis (P < 0·001) and improved callus grade (P < 0·001). All these were evaluated by Wilcoxon's signed rank sum test. None of the patients of risk-group-3 (history of foot ulceration) showed recurrence of callus-related foot ulcers. Six high-risk patients developed foot ulceration during the programme because of minor injury, but the ulcers healed without development of gangrene.
A nurse-based foot care programme is effective in preventing diabetic foot in diabetic patients.
本研究旨在评估针对糖尿病患者的预防足部护理护理方案的有效性。
足部并发症在糖尿病患者中很常见，预防这些并发症需要进行足部护理。然而，关于足部护理护理对糖尿病足的发生率和复发率的影响的信息很少。
我们基于国际糖尿病足工作组制定了糖尿病足部护理方案。我们研究了 88 名参加我们足部护理计划的患者，随访时间为 2 年，数据收集时间为 2005 年 4 月至 2009 年 3 月。根据风险分类将患者分为四组，并接受足部护理。我们评估了足部溃疡或复发以及非溃疡足部状况的发生率。使用配对 t 检验和 McNemar 检验分析患者的特征，使用 Wilcoxon 符号秩和检验分析足癣严重程度评分和胼胝分级的变化。
该方案降低了足癣的严重程度评分（P < 0.001），并改善了胼胝分级（P < 0.001）。所有这些都通过 Wilcoxon 符号秩和检验进行评估。无 3 级风险组（足部溃疡史）患者出现与胼胝相关的足部溃疡复发。6 名高危患者在该方案中因轻微损伤而发生足部溃疡，但溃疡愈合而无坏疽发展。
以护士为基础的足部护理方案可有效预防糖尿病患者的糖尿病足。
