Formosa Cynthia, Borg Anthea, Papanas Nikolaos, Mizzi Stephen
Faculty of Health Sciences, University of Malta.
Department of Health, Malta.
Exp Clin Endocrinol Diabetes. 2020 Apr;128(4):244-245. doi: 10.1055/a-0808-4111. Epub 2018 Dec 17.
The literature reports that people living with diabetes do not adhere to their prescribed therapeutic footwear as instructed. The reason for this is still uncertian although certain footwear characteristics seem to reasons reported leading to reduced level of adherence.
To explore the reasons for current adherence or otherwise to prescribed stock footwear amongst patients living with type-2 diabetes.
An exploratory qualitative design method using an Interpretative Phenomenological Analysis [IPA] was employed in this research. Employing purposive sampling, twelve participants were recruited and interviewed. Interviews were recorded, transcribed and later analysed.
Common themes that emerged from this study fell under 2 main categories including 'Adherence' and 'Non - Adherence' to wearing the prescribed stock footwear. A number of themes were identified with regards to the reasons for such adherence or otherwise by respective participants including footwear characteristics, service provision, peer pressure and the patient's knowledge and attitudes.
This study demonstrated suboptimal adherence to wearing therapeutic footwear among people with type 2 diabetes. Although the literature highlights the importance of adherence to therapeutic footwear in high risk populations for the prevention of diabetic foot complications, this study provides the reasons as to why patients still do not comply in wearing their prescribed therapeutic footwear. In order to improve behavioral changes patients would require on-going care, empowerment and support combined with educational programs to achieve a higher level of adherence. More research is warranted to explore further psychosocial interventions in diabetes care.
文献报道,糖尿病患者并未按医嘱坚持使用规定的治疗性鞋具。尽管某些鞋具特征似乎是导致依从性降低的原因,但具体原因仍不明确。
探究2型糖尿病患者对规定的库存鞋具目前依从或不依从的原因。
本研究采用探索性定性设计方法,即诠释现象学分析法[IPA]。采用目的抽样法,招募了12名参与者并进行访谈。访谈进行录音、转录,随后进行分析。
本研究中出现的常见主题分为两大类,包括对规定库存鞋具的“依从”和“不依从”。就各自参与者依从或不依从的原因确定了若干主题,包括鞋具特征、服务提供、同伴压力以及患者的知识和态度。
本研究表明2型糖尿病患者对治疗性鞋具的依从性欠佳。尽管文献强调了在高危人群中依从治疗性鞋具对预防糖尿病足并发症的重要性,但本研究给出了患者仍不遵守医嘱穿着规定治疗性鞋具的原因。为了改善行为改变,患者需要持续的护理、赋权和支持,并结合教育项目以实现更高水平的依从性。有必要开展更多研究,以进一步探索糖尿病护理中的社会心理干预措施。