Saurabh Suman, Sarkar Sonali, Selvaraj Kalaiselvi, Kar Sitanshu Sekhar, Kumar S Ganesh, Roy Gautam
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Indian J Endocrinol Metab. 2014 Jan;18(1):106-10. doi: 10.4103/2230-8210.126587.
The burden of diabetes and its foot complications is increasing in India. Prevention of these complications through foot care education should be explored. The objective of our study was to assess the risk factors of poor diabetic foot care and to find the effectiveness of health education in improving foot care practice among diabetes patients.
A structured pre-tested questionnaire was administered to the outpatients of a rural health center with type 2 diabetes. Awareness regarding diabetes, care of diabetes and foot care practice ware assessed and scored. Individual and group health education focusing on foot care was performed. Foot care practice was reassessed after 2 weeks of education.
Only 54% were aware that diabetes could lead to reduced foot sensation and foot ulcers. Nearly 53% and 41% of the patients had good diabetes awareness and good diabetes care respectively. Only 22% of the patients had their feet examined by a health worker or doctor. The patients with poor, satisfactory and good practice scores were 44.7%, 35.9% and 19.4% respectively. Low education status, old age and low awareness regarding diabetes were the risk factors for poor practice of foot care. Average score for practice of foot care improved from 5.90 ± 1.82 to 8.0 ± 1.30 after 2 weeks of health education. Practice related to toe space examination, foot inspection and foot wear inspection improved maximally.
Foot care education for diabetics in a primary care setting improves their foot care practice and is likely to be effective in reducing the burden of diabetic foot ulcer.
在印度，糖尿病及其足部并发症的负担正在增加。应探索通过足部护理教育来预防这些并发症。我们研究的目的是评估糖尿病足部护理不佳的风险因素，并确定健康教育在改善糖尿病患者足部护理实践方面的有效性。
对一家农村健康中心的2型糖尿病门诊患者进行了一份经过预测试的结构化问卷。评估并记录了他们对糖尿病、糖尿病护理和足部护理实践的认知情况及得分。开展了以足部护理为重点的个体和小组健康教育。在教育2周后重新评估足部护理实践情况。
只有54%的人知道糖尿病会导致足部感觉减退和足部溃疡。分别有近53%和41%的患者对糖尿病有良好的认知和良好的糖尿病护理。只有22%的患者让卫生工作者或医生检查过足部。足部护理实践得分差、满意和好的患者分别为44.7%、35.9%和19.4%。教育程度低、年龄大和对糖尿病认知度低是足部护理实践不佳的风险因素。经过2周的健康教育后，足部护理实践的平均得分从5.90±1.82提高到了8.0±1.30。与脚趾间隙检查、足部检查和鞋类检查相关的实践改善最大。
在初级保健机构对糖尿病患者进行足部护理教育可改善他们的足部护理实践，并且可能有效减轻糖尿病足溃疡的负担。
