Takehara Kimie, Amemiya Ayumi, Mugita Yuko, Tsunemi Yuichiro, Seko Yoko, Ohashi Yumiko, Ueki Kohjiro, Kadowaki Takashi, Oe Makoto, Nagase Takashi, Ikeda Mari, Sanada Hiromi
In Tokyo, Japan, Kimie Takehara, PhD, RN, is a Lecturer, Department of Nursing Administration/Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo; Ayumi Amemiya, PhD, RN, is an Assistant Professor, Department of Nursing Physiology, Graduate School of Nursing, Chiba University; Yuko Mugita, PhD, RN, is an Assistant Professor, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo; Yuichiro Tsunemi, PhD, MD, is an Associate Professor, Department of Dermatology, Tokyo Women's Medical University; Yoko Seko, RN, is a Nurse Manager, The University of Tokyo Hospital; Yumiko Ohashi, RN, is a Ward Nurse, The University of Tokyo Hospital; Kohjiro Ueki, PhD, MD, is a Director, Diabetes Research Center, Research Institute National Center for Global Health and Medicine; Takashi Kadowaki, PhD, MD, is a Professor, Department of Metabolic Diseases, Graduate School of Medicine, The University of Tokyo; Makoto Oe, PhD, RN, is a Project Associate Professor, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo; Takashi Nagase, PhD, MD, is a Project Lecturer, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo; Mari Ikeda, PhD, RN, is a Professor, School of Nursing, Nursing Administration, Tokyo Women's Medical University; and Hiromi Sanada, PhD, WOCN, RN, is a Professor, Department of Nursing Administration/Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
Adv Skin Wound Care. 2017 Nov;30(11):510-516. doi: 10.1097/01.ASW.0000525903.07883.8f.
To examine the correlations between elements of feet-washing behavior, presence of tinea pedis (TP), and patients' background characteristics in order to identify a concrete intervention method to prevent TP.
A cross-sectional study of 30 patients with diabetes (16 with TP) who were admitted to or visited the university hospital.
The presence of TP was confirmed by the detection of dermatophytes by direct microscopy. Data on elements of feet-washing behavior, such as scrubbing between the toes, were collected by observing recorded videos of participants normally washing their feet as they do at home. The patients' background characteristics included demographic data; diabetes-related factors; patient knowledge regarding diabetes, foot problems, and TP prevention; purpose for feet washing; and any difficulties in feet washing.
The number of times patients scrubbed between their toes while washing with soap was significantly lower in patients with TP (odds ratio, 0.95; P = .036; with a cutoff value of 35 times) and those who had difficulty in reaching their feet with their hands (B = -14.42, P = .041).
An effective foot-washing protocol should include specific instructions for patients to scrub between their toes at least 35 times in all 8 spaces while washing with soap. Appropriate advice is also needed for individuals who have difficulty reaching their feet with their hands. Education about appropriate foot-washing behavior may potentially prevent TP.
