Ahmad Sharoni Siti Khuzaimah, Minhat Halimatus Sakdiah, Mohd Zulkefli Nor Afiah, Baharom Anisah
Nursing Department, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia.
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Int J Older People Nurs. 2016 Sep;11(3):214-39. doi: 10.1111/opn.12112. Epub 2016 Feb 25.
To assess the effectiveness of health education programmes to improve foot self-care practices and foot problems among older people with diabetes.
The complications of diabetes among older people are a major health concern. Foot problems such as neuropathy, ulcer and ultimately amputation are a great burden on older people with diabetes. Diabetes foot education programmes can influence the behaviour of older people in practising foot self-care and controlling the foot problems. However, the educational approaches used by the educators are different. Therefore, it is important to assess the education programmes from various evidence-based practices.
Six databases, EBSCOhost medical collections (MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection), SAGE, Wiley Online Library, ScienceDirect, SpringerLink and Web of Science, were used to search for articles published from January 2000 to March 2015. The search was based on the inclusion criteria and keywords including 'foot', 'care' and 'diabetes'. Fourteen studies were assessed and reviewed in the final stage.
Health education programmes varied according to their design, setting, approach, outcome measured and results. Foot assessment, verbal and written instructions and discussion were proved to improve the foot self-care and foot problems. Subsequent follow-ups and evaluations had a significant effect. An improvement was observed in foot self-care scores and foot problems (such as neuropathy, foot disability, lesion, ulcer, tinea pedis and callus grade) after implementation of the health education programme.
The findings of this study support the claim that a health education programme increases the foot self-care scores and reduces the foot problems. However, there were certain methodological concerns in the reviewed articles, indicating the need for further evaluation. In future, researchers and practitioners must implement a vigorous education programme focusing on diabetes foot self-care among the older population.
评估健康教育项目对改善老年糖尿病患者足部自我护理行为及足部问题的效果。
老年人糖尿病并发症是主要的健康问题。诸如神经病变、溃疡乃至截肢等足部问题给老年糖尿病患者带来巨大负担。糖尿病足部教育项目能够影响老年人足部自我护理行为并控制足部问题。然而，教育者采用的教育方法各异。因此，从各种循证实践角度评估教育项目很重要。
使用六个数据库，即EBSCOhost医学数据库（MEDLINE、CINAHL、心理学与行为科学数据库）、SAGE、Wiley Online Library、ScienceDirect、SpringerLink和Web of Science，检索2000年1月至2015年3月发表的文章。检索基于纳入标准及包括“足部”“护理”和“糖尿病”在内的关键词。最终阶段评估并综述了14项研究。
健康教育项目在设计、实施环境、方法、测量结果及成效方面各不相同。足部评估、口头与书面指导及讨论被证明可改善足部自我护理及足部问题。后续的随访与评估有显著效果。实施健康教育项目后，足部自我护理评分及足部问题（如神经病变、足部残疾、损伤、溃疡、足癣和胼胝等级）有所改善。
本研究结果支持健康教育项目能提高足部自我护理评分并减少足部问题这一观点。然而，综述文章存在某些方法学问题，表明需要进一步评估。未来，研究人员和从业者必须针对老年人群实施一项侧重于糖尿病足部自我护理的有力教育项目。
