Andersson Susanne, Scandurra Isabella, Nyström Ulrika, Varemo Marika, Hellstrand Tang Ulla
Department of Health Sciences, University West, Trollhättan, Sweden.
Centre of Empirical Research in Information Systems, Örebro University, Örebro, Sweden.
JMIR Nurs. 2023 Jul 18;6:e45501. doi: 10.2196/45501.
Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.
The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it "foot side" when examining patients with diabetes.
Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled "Optimised care of persons with diabetes and foot complications," with Västra Götaland Region as the responsible health care authority, where the results will be further developed.
Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.
The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.
ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.
糖尿病对公众健康的威胁日益增加，足部并发症等继发性疾病很常见。足部溃疡会影响个人生活质量，给社会带来巨大成本。定期足部检查可预防足部溃疡，在瑞典乃至全球都是推荐的方法。尽管有现有指南，但足部检查的执行存在差异，导致护理不平等。本研究开发了一种基于当前指南的结构化足部检查表，作为日常数字化支持的第一步，并得到了糖尿病医疗专业人员的验证。
本研究旨在通过评估医疗保健专业人员在为糖尿病患者进行检查时“床边”使用该检查表的经验，来验证一种结构化足部检查表。
在一个焦点小组中进行了半结构化访谈，并分别与8位来自不同糖尿病专业的受访者进行了访谈，询问他们在临床实践中使用该检查表的经验。使用定性内容分析法对用户数据进行归纳分析。该研究是一个名为“糖尿病和足部并发症患者的优化护理”的更大项目的一部分，韦斯特罗斯-哥德堡地区是负责的医疗保健机构，研究结果将在此基础上进一步完善。
使用该检查表的经验表明，它通过提供概述和清晰的结构简化了足部检查。使用该检查表使个体之间的工作流程差异明显。人们认为常规实施该检查表将有助于更统一的执行。当患者患有足部溃疡时，指南中确定的风险类别被认为相互矛盾。例如，慢性溃疡和胼胝的定义存在不确定性。期望未来的数字格式将简化文档记录并阐明足部检查，同时有助于所有相关人员获取最新和相关数据。
足部检查表在预防性足部检查中作为一种支持工具效果良好，为决策奠定了基础，并有助于按照当前指南进行更统一、更安全的足部检查，实现更多护理平等。
ClinicalTrials.gov NCT05692778；https://clinicaltrials.gov/ct2/show/NCT05692778 。
