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埃塞俄比亚东北部德西转诊医院糖尿病患者糖尿病足自我护理知识与实践及相关因素:混合方法研究

Knowledge and Practice on Diabetic Foot Self-Care and Associated Factors Among Diabetic Patients at Dessie Referral Hospital, Northeast Ethiopia: Mixed Method.

作者信息

Tuha Abdu, Getie Faris Abebe, Andualem Ababil, Ahmed Mohammed Solomon

机构信息

Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

出版信息

Diabetes Metab Syndr Obes. 2021 Mar 17;14:1203-1214. doi: 10.2147/DMSO.S300275. eCollection 2021.

Abstract

INTRODUCTION

Diabetic foot ulcer is a serious and disabling complication of diabetes mellitus that consists of lesions in the deep tissues resulting in lower extremity amputations. The incidence of diabetic foot ulcers has increased due to an increased prevalence of diabetes mellitus. This study assessed the knowledge and practice of diabetic foot self-care among diabetic patients attending Dessie referral hospital.

METHODS

A facility-based explanatory sequential mixed method was used from April 03/2019 to May 09/2019. The quantitative method employed an institutional-based cross-sectional study design using a structured questionnaire. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were made using the statistical package for social sciences version 20. Then, a phenomenological study was employed among key informants and content analysis was performed.

RESULTS

Sixty-eight (19.8%) of patients with diabetes developed complication, among them 97 (28%) had foot ulcer. Nearly two-third (217 (61.3%): 95% CI (57.6-68.3%)) and 134 (39%; 95% CI:34.3-45.1%) of patients with diabetes had good knowledge and practice on diabetic foot self-care, respectively. Diabetic nephropathy ((AOR): 0.03, 95% CI (0.00-0.27)) was associated with knowledge on foot self-care. Practice of foot self-care was associated with female ((AOR: 2.07, 95% CI (1.04-4.12)), age 21-30 ((AOR: 6.42, 95% CI (1.54-26.8)), 31-40 years ((AOR: 7.4, 95% CI (1.42-39.05)), 41-50 years ((AOR: 8.4, 95% CI (1.4-50.6)), single ((AOR: 0.35, 95% CI (0.150-0.81)), living in rural ((AOR: 0.31, 95% CI (0.18-0.545)) and no comorbidity ((AOR: 0.406, 95% CI (0.18-0.88)). Key informants were not compliant, confused and negligent to foot self-care.

CONCLUSION

Nearly two-third and more than one-third of patients with diabetes had good knowledge and practice on diabetic foot self-care, respectively. Patients lack proper knowledge regarding self-care and how it is practiced. Patient education and proper management of diabetic foot ulcers are recommended to reduce, delay, or prevent complications.

摘要

引言

糖尿病足溃疡是糖尿病一种严重且致残的并发症,表现为深部组织损伤,可导致下肢截肢。由于糖尿病患病率上升,糖尿病足溃疡的发病率也有所增加。本研究评估了德西转诊医院糖尿病患者对糖尿病足自我护理的知识和实践情况。

方法

于2019年4月3日至2019年5月9日采用基于机构的解释性序列混合方法。定量方法采用基于机构的横断面研究设计,使用结构化问卷。采用简单随机抽样技术选择研究参与者。使用社会科学统计软件包第20版进行描述性和推断性统计。然后,对关键信息提供者进行现象学研究并进行内容分析。

结果

68名(19.8%)糖尿病患者出现并发症,其中97名(28%)患有足溃疡。分别有近三分之二(217名(61.3%):95%置信区间(57.6 - 68.3%))和134名(39%;95%置信区间:34.3 - 45.1%)糖尿病患者对糖尿病足自我护理有良好的知识和实践。糖尿病肾病((比值比):0.03,95%置信区间(0.00 - 0.27))与足部自我护理知识相关。足部自我护理实践与女性((比值比:2.07,95%置信区间(1.04 - 4.12))、年龄21 - 30岁((比值比:6.42,95%置信区间(1.54 - 26.8))、31 - 40岁((比值比:7.4,95%置信区间(1.42 - 39.05))、41 - 50岁((比值比:8.4,95%置信区间(1.4 - 50.6))、单身((比值比:0.35,95%置信区间(0.150 - 0.81))、居住在农村((比值比:0.31,95%置信区间(0.18 - 0.545))以及无合并症((比值比:0.406,95%置信区间(0.18 - 0.88))相关。关键信息提供者在足部自我护理方面不依从、困惑且疏忽。

结论

分别有近三分之二和超过三分之一的糖尿病患者对糖尿病足自我护理有良好的知识和实践。患者缺乏关于自我护理及其实施方式的正确知识。建议开展患者教育并对糖尿病足溃疡进行适当管理,以减少、延缓或预防并发症。

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