Baba Mendel, Duff Jenny, Foley Laurie, Davis Wendy A, Davis Timothy M E
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia; Podiatric Medicine Unit, University of Western Australia, Crawley, Perth, Western Australia, Australia.
Diabetes WA, Subiaco, Western Australia, Australia.
Prim Care Diabetes. 2015 Apr;9(2):155-62. doi: 10.1016/j.pcd.2014.05.004. Epub 2014 Jun 12.
To compare the effectiveness of two different methods of education on foot health, behaviours and attitudes in patients with type 2 diabetes.
Community-based patients were consecutively allocated to written education (Group A) or an interactive educator-led session (Group B). A quantitative Foot Score (maximum 90 points score based on severity of treatable pathology), the Nottingham Assessment of Functional Foot Care (NAFFC) survey score (maximum 30 points reflecting frequency of foot care behaviours) and a 6-question survey of attitudes to foot complications were administered at baseline and 3 months.
154 patients (mean±SD age 68±10 years, 59.7% males, median [interquartile range] diabetes duration 11.5 [5.6-18.9] years) were recruited. There was a greater change (Δ) in Foot Score from baseline to 3 months in Group A (8.3±3.6, Δ-1.8 (95% CI: -2.4 to -1.2) vs Group B (6.8±2.6, Δ-0.1 (-0.7 to 0.4); P<0.001), but no change in NAFFC survey score in either group (P=0.13). In the attitudes survey, Group B felt they better understood how to prevent foot complications than Group A after education (P=0.031).
Written information was more effective at improving foot health while interactive education improved confidence in undertaking preventive measures, suggesting that the most effective foot care education should include both components.
比较两种不同教育方法对2型糖尿病患者足部健康、行为及态度的影响。
将社区患者连续分配至书面教育组（A组）或由教育者主导的互动课程组（B组）。在基线和3个月时进行定量足部评分（基于可治疗病理的严重程度，最高90分）、诺丁汉功能性足部护理评估（NAFFC）调查评分（最高30分，反映足部护理行为的频率）以及关于足部并发症态度的6个问题的调查。
共招募了154例患者（平均±标准差年龄68±10岁，男性占59.7%，糖尿病病程中位数[四分位间距]为11.5[5.6 - 18.9]年）。从基线到3个月，A组的足部评分变化（Δ）更大（8.3±3.6，Δ - 1.8（95%CI： - 2.4至 - 1.2）），而B组为（6.8±2.6，Δ - 0.1（ - 0.7至0.4）；P<0.001），但两组的NAFFC调查评分均无变化（P = 0.13）。在态度调查中，教育后B组感觉他们比A组更清楚如何预防足部并发症（P = 0.031）。
书面信息在改善足部健康方面更有效，而互动教育提高了采取预防措施的信心，这表明最有效的足部护理教育应包括这两个方面。
