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[2型糖尿病患者的糖尿病足神经病变及相关因素]

[Diabetic Foot Neuropathy and Related Factors in Patients With Type 2 Diabetes Mellitus].

作者信息

Chen Tzu-Yu, Lin Chia-Huei, Chang Yue-Cune, Wang Chih-Hsin, Hung Yi-Jen, Tzeng Wen-Chii

机构信息

MSN, RN, Preceptor, Department of Nursing, St. Mary's Junior College of Medicine, Nursing and Management, Taiwan, ROC.

PhD, RN, Supervisor, Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Songshan Branch, and Adjunct Assistant Professor, School of Nursing, National Defense Medical Center, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2018 Jun;65(3):28-37. doi: 10.6224/JN.201806_65(3).06.

Abstract

BACKGROUND

Patients with type 2 diabetes mellitus (T2DM) face a higher risk of diabetic foot neuropathy, which increases the risk of death. The early detection of factors that influence diabetic neuropathy reduces the risk of foot lesions, including foot ulcerations, lower extremity amputation, and mortality.

PURPOSE

To explore the demographic, disease-characteristic, health-literacy, and foot-self-care-behavior factors that affect diabetic foot neuropathy in patients with T2DM.

METHODS

A case-control study design was employed in which cases (Michigan Neuropathy Screening Instrument, MNSI) ≥ 2 were matched to controls based on age and gender in a medical center. A total of 114 patients diagnosed with T2DM in a medical center were recruited as participants. Data were collected using a structured questionnaire. The collected data were analyzed using Fisher's exact test, Mann-Whitney U test, and logistic regression.

RESULTS

The results of multiple logistic regression showed that glycated hemoglobin (B = 1.696, p = .041) and communication and critical health literacy (B = -0.082, p = .034) were significant factors of diabetic foot neuropathy.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings of this study suggest that nurses should assess the health literacy of patients with T2DM before providing health education and should develop a specific foot-care intervention for individuals with poor glycemic control.

摘要

背景

2型糖尿病(T2DM)患者面临更高的糖尿病足神经病变风险,这会增加死亡风险。早期发现影响糖尿病神经病变的因素可降低足部病变风险,包括足部溃疡、下肢截肢和死亡率。

目的

探讨影响T2DM患者糖尿病足神经病变的人口统计学、疾病特征、健康素养和足部自我护理行为因素。

方法

采用病例对照研究设计,在一家医疗中心,将密歇根神经病变筛查工具(MNSI)评分≥2的病例根据年龄和性别与对照组进行匹配。总共招募了114名在医疗中心被诊断为T2DM的患者作为参与者。使用结构化问卷收集数据。采用Fisher精确检验、Mann-Whitney U检验和逻辑回归对收集的数据进行分析。

结果

多元逻辑回归结果显示,糖化血红蛋白(B = 1.696,p = .041)以及沟通和关键健康素养(B = -0.082,p = .034)是糖尿病足神经病变的重要因素。

结论/对实践的启示:本研究结果表明,护士在提供健康教育之前应评估T2DM患者的健康素养,并应为血糖控制不佳的个体制定特定的足部护理干预措施。

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