Zhu Wangqiao, Zhang Lifang, Long Sulan, Liu Jia, Qin Yingying, Huang Caimei
At Youjiang Medical University for Nationalities, Youjiang District, Baise, China, Wangqiao Zhu, PhD, is Deputy Director of the Teaching and Research Office; and Lifang Zhang, PhD, is Dean. Sulan Long, PhD, is Research Assistant, Faculty of Nursing, Nanchang Medical College, Jiangxi Province, Nanchang, China. Also at Youjiang Medical University for Nationalities, Jia Liu, PhD, is Research Assistant, Faculty of Nursing. Yingying Qin, MD, and Caimei Huang, MD, are Chief Nurses, Affiliated Hospital of Youjiang Medical University for Nationalities.
Adv Skin Wound Care. 2025 Jul 1;38(6):316-322. doi: 10.1097/ASW.0000000000000290. Epub 2025 Mar 27.
Several prior studies have investigated determinants linked to the insufficient delivery of diabetic foot self-care education (DFSE), with some specifically concentrating on rural environments. Individuals with diabetes, especially those at risk of foot ulcers, should acquire the skills necessary for daily foot inspection, proper toenail-trimming techniques, consistent use of appropriate footwear, and a thorough understanding of preventive measures against ulcers.
To explore the challenges associated with delivering DFSE among nurses in rural areas.
The authors used a qualitative descriptive design. Fourteen participants were purposively selected from two township health centers. Data were collected through focus group discussions. All interviews were analyzed using thematic analysis.
The primary challenges to delivering DFSE in rural areas were identified and categorized into four key themes: limited human resources, excessive patient visits, high patient turnover rate, and understanding gaps in collaborative medical care.
Limited diabetic nursing resources hinder patient education, affecting those with high admissions and extensive care needs. Excessive patient visits pose a challenge, overshadowing education efforts, especially during peak times after festival celebrations. Swift patient turnover and communication gaps among healthcare providers are significant barriers to timely health education. Nurses must enhance interdisciplinary communication for quality teaching and patient care. Integrating technology into nursing education can improve flexibility and accessibility. For the reform of China's national primary healthcare system, attracting and retaining skilled healthcare professionals in primary care should involve incentives and professional development.
此前已有多项研究调查了与糖尿病足自我护理教育（DFSE）提供不足相关的决定因素，其中一些研究特别关注农村环境。糖尿病患者，尤其是有足部溃疡风险的患者，应掌握日常足部检查、正确修剪趾甲技术、持续使用合适鞋类以及全面了解溃疡预防措施所需的技能。
探讨农村地区护士开展DFSE所面临的挑战。
作者采用定性描述性设计。从两个乡镇卫生院有目的地选取了14名参与者。通过焦点小组讨论收集数据。所有访谈均采用主题分析法进行分析。
确定了农村地区开展DFSE的主要挑战，并将其分为四个关键主题：人力资源有限、患者就诊过多、患者周转率高以及合作医疗中的理解差距。
糖尿病护理资源有限阻碍了患者教育，影响了那些入院率高且护理需求广泛的患者。患者就诊过多构成了一项挑战，使教育工作黯然失色，尤其是在节日庆祝后的高峰期。患者快速周转以及医疗服务提供者之间的沟通差距是及时开展健康教育的重大障碍。护士必须加强跨学科沟通，以提供高质量教学和患者护理。将技术融入护理教育可以提高灵活性和可及性。对于中国国家基层医疗体系的改革，吸引并留住基层医疗领域的熟练医疗专业人员应涉及激励措施和专业发展。
