Liu Shuhong, Ding Hexiao, Li Dandan, Lu Fen, Luo Gumei, He Yujin, Li Hui, Zeng Xiuhong, Li Kaixin, Gong Dong-E, Hu Xiling, Chen Yanming, Yang Xubin
Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology & Guangzhou Municipal Key Laboratory of Mechanistic and Translational Obesity Research, the Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou, Guangdong, 510630, China.
Int J Nurs Stud Adv. 2025 Jan 5;8:100291. doi: 10.1016/j.ijnsa.2025.100291. eCollection 2025 Jun.
Research has shown that DPN affects 50 % of individuals with diabetes and, in severe cases, can lead to amputation or death. Interventions led by doctors for DPN have demonstrated limited effectiveness in delaying its onset and progression. Nevertheless, there is an increasing recognition of the significance of nurse-led screening and health education in the early detection and slowing down of DPN.
The present study conducted a retrospective analysis of medical records of 10,191 diabetic patients from 2019 to 2023, who also regularly attended outpatient clinics. Patients with incomplete medical data, transfers, critical conditions or death, existing foot ulcers or amputations, bedridden or uncooperative individuals (5,470 individuals) were excluded, and a total of 4,721 individuals were selected for analysis. The screening and intervention components of the FSCHE program were all led by nurses. A total of 2022 participants received foot screening and customized health education (FSCHE) program, while 2699 participants recevied regular care. The primary outcome is on determining the prevalence rate of DPN among all the included diabetic patients. The data was collected through experimental tests and nurse-led foot screening. Prevalence rates were reported as the number of cases per 1000 individuals. Odds Ratios were calculated to approximate Risk Ratios to determine the effectiveness of the FSCHE program.
The prevalence of DPN in diabetic patients who received the FSCHE program decreased from 557 cases per 1000 individuals in 2019 to 199 cases per 1000 individuals in 2023. The hospitalization duration decreased from 11.2 days to 7.59 days. The risk of DPN in diabetic patients participating in the FSCHE program was 0.741 times higher than that of regular diabetes care (RR [95 % CI]: 0.741 [0.654, 0.840], < 0.001). The DPN-related risk factors showed promising control results as well.
In this observational study conducted among Chinese patients with diabetes, it was found that the nurse-led FSCHE program effectively manages DPN and its associated risk factors. These results highlight the importance of employing objective screening tools to detect DPN at an early stage, as well as the significance of nurse-led interventions in promoting healthy behaviors and preventing the development and progression of DPN.
研究表明，糖尿病周围神经病变（DPN）影响50%的糖尿病患者，在严重情况下，可导致截肢或死亡。由医生主导的针对DPN的干预措施在延缓其发病和进展方面效果有限。然而，人们越来越认识到护士主导的筛查和健康教育在DPN的早期检测和减缓方面的重要性。
本研究对2019年至2023年期间10191例定期到门诊就诊的糖尿病患者的病历进行了回顾性分析。排除医疗数据不完整、转院、病情危急或死亡、已有足部溃疡或截肢、卧床或不合作的患者（5470例），共选取4721例患者进行分析。FSCHE项目的筛查和干预部分均由护士主导。共有2022名参与者接受了足部筛查和定制健康教育（FSCHE）项目，而2699名参与者接受了常规护理。主要结果是确定所有纳入的糖尿病患者中DPN的患病率。数据通过实验测试和护士主导的足部筛查收集。患病率以每1000人中的病例数报告。计算比值比以近似风险比，以确定FSCHE项目的有效性。
接受FSCHE项目的糖尿病患者中DPN的患病率从2019年的每1000人557例降至2023年的每1000人199例。住院时间从11.2天降至7.59天。参与FSCHE项目的糖尿病患者发生DPN的风险比常规糖尿病护理高0.741倍（RR [95% CI]：0.741 [0.654, 0.840]，< 0.001）。DPN相关风险因素也显示出良好的控制效果。
在这项针对中国糖尿病患者的观察性研究中，发现护士主导的FSCHE项目能有效管理DPN及其相关风险因素。这些结果凸显了采用客观筛查工具早期检测DPN的重要性，以及护士主导的干预措施在促进健康行为和预防DPN发生及进展方面的重要性。
