Simonsen Morten Bilde, Christiansen Sofie Ladekarl, Pedersen Mona Kyndi, Røikjer Johan, Croosu Suganthiya Santhiapillai, Leutscher Peter Derek Christian, Ejskjaer Niels
North Denmark Regional Hospital, Center for Clinical Research, Hjorring, Denmark.
Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
SAGE Open Med. 2024 Jun 6;12:20503121241258841. doi: 10.1177/20503121241258841. eCollection 2024.
Preventative foot self-care is vital for avoiding diabetic foot ulcer episodes and lowering the risk of amputations. Yet, it demands high levels of health literacy and cognitive function.
To investigate health literacy and cognitive function in persons presenting with a diabetic foot ulcer.
Participants with type 2 diabetes were recruited from the tertiary foot clinic at Steno Diabetes Center North Denmark. The European Health Literacy Survey Questionnaire and Addenbrooke's Cognitive Examination were applied. A semi-structured interview guide was developed to evaluate foot self-care knowledge, attitude, and practice. The qualitative data were analyzed with a deductive approach based on a qualitative thematic analysis model. Subsequently, an integrated analysis of the quantitative and qualitative results was conducted.
The participants ( = 12) had a mean age of 62.6 ± 8.4 years, and 11 were males. The mean diabetes duration was 15.9 ± 8.9 years. Eight participants had a recurrent diabetic foot ulcer. The health literacy level was sufficient in nine participants, and cognitive function was normal in five participants. Three different profiles related to foot self-care (, , or , respectively) were constructed by the final integrated analysis: profile refers to taking preventative action in concordance with knowledge and attitude, an profile to taking action in response to a situation, but challenged by conflicting levels of knowledge and attitude, and a profile to not taking action.
The study suggests that people presenting with a diabetic foot ulcer have different foot self-care profiles based on person-specific health literacy, cognitive function, and knowledge, attitude, and practice element characteristics, highlighting the need for individualized education and intervention strategy instead of a one-size-fits-all approach.
预防性足部自我护理对于避免糖尿病足溃疡发作和降低截肢风险至关重要。然而，这需要较高的健康素养和认知功能。
调查患有糖尿病足溃疡患者的健康素养和认知功能。
从丹麦北部斯滕诺糖尿病中心的三级足部诊所招募2型糖尿病患者。应用欧洲健康素养调查问卷和剑桥认知功能测试。制定了一份半结构化访谈指南，以评估足部自我护理知识、态度和实践。基于定性主题分析模型，采用演绎法对定性数据进行分析。随后，对定量和定性结果进行综合分析。
参与者（n = 12）的平均年龄为62.6±8.4岁，其中11人为男性。平均糖尿病病程为15.9±8.9年。8名参与者有复发性糖尿病足溃疡。9名参与者的健康素养水平足够，5名参与者的认知功能正常。最终的综合分析构建了三种与足部自我护理相关的不同类型（分别为A、B或C类型）：A类型是指根据知识和态度采取预防行动，B类型是指针对某种情况采取行动，但受到知识和态度冲突水平的挑战，C类型是指不采取行动。
该研究表明，患有糖尿病足溃疡的患者基于个人特定的健康素养、认知功能以及知识、态度和实践要素特征，具有不同的足部自我护理类型，这突出了需要个性化教育和干预策略，而不是一刀切的方法。
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