School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.
Int Wound J. 2018 Jun;15(3):375-382. doi: 10.1111/iwj.12874. Epub 2018 Jan 3.
Foot ulceration is a devastating and costly consequence of diabetes. Hyperbaric oxygen therapy is recognised as an adjunctive therapy to treat diabetes-related foot ulceration, yet uptake is low. Semi-structured interviews were conducted with 16 podiatrists who manage patients with foot ulcers related to diabetes to explore their perceptions of, and the barriers/facilitators to, referral for hyperbaric oxygen. Podiatrists cited logistical issues such as location of facilities as well as poor communication pathways, lack of delegation and lack of follow up when patients presented for hyperbaric treatment. In general, podiatrists had an understanding of the premise of hyperbaric oxygen therapy and evidence to support its use but could only provide very limited citations of key papers and guidelines to support their position. Podiatrists stated that they felt a patient was lost from their care when referred for hyperbaric oxygen and that aftercare might not be adequate. Improved referral and delegation pathways for patients presenting for hyperbaric oxygen, as well as the provision of easily accessible evidence to support this therapy, could help to increase podiatrists' confidence in deciding whether or not to recommend their patients for hyperbaric oxygen therapy.
足部溃疡是糖尿病的一种严重且代价高昂的后果。高压氧治疗被认为是治疗糖尿病相关足部溃疡的辅助疗法，但采用率很低。对 16 名管理糖尿病相关足部溃疡患者的足病医生进行了半结构化访谈，以探讨他们对高压氧治疗转介的看法，以及转介的障碍/促进因素。足病医生提到了一些后勤问题，如设施的位置以及沟通途径不畅、缺乏委托和患者接受高压氧治疗时缺乏后续跟进。总的来说，足病医生了解高压氧治疗的前提和支持其使用的证据，但只能提供很少的关键论文和指南来支持他们的立场。足病医生表示，当患者被转介接受高压氧治疗时，他们就失去了对患者的治疗，而且后续治疗可能不够充分。改善患者接受高压氧治疗的转介和委托途径，并提供易于获取的支持该治疗的证据，可以帮助提高足病医生在决定是否推荐患者接受高压氧治疗方面的信心。
