Patient Education for the Prevention of Diabetic Foot Wounds-Juniper Publishers
Authored by Emine Kir Bifer
Mini Rewiew
Diabetes Mellitus is a metabolic disease with
systemic and chronic complications, the incidence of which is growing.
Among the complications commonly seen in diabetics are diabetic
neuropathy and ischemia, the latter being the result of a peripheral
artery disease. These complications, in combination with excessive
pressure and infection, cause what is referred to as diabetic foot,
which can lead to foot loss, with its accompanying psychological,
physical, social and economic impacts [1,2]
of our organs feet are the most vulnerable to injury, trauma and
infection both in diabetics and in non-diabetics. However the foot is
more easily injured in diabetics. In the presence of peripheral artery
disease and visual impairment the loss of protective sensation in the
feet and toes the reduction of blood flow to the feet and the appearance
of cracking and drying due to moisture excessive sweating pose a risk
to the feet [3].
The realization of the importance of foot care education for the prevention of foot problems in diabetics was long in coming [4]. By the 1970s, the role of education in treating diabetes had become commonly acknowledged [5].
Despite the inclusion of foot care education in general diabetes
education many diabetics still failed to look after their feet so foot
problems were a common occurrence [6]. The most important aim of diabetic foot care education is the prevention of potential injuries due to foot trauma [7].
There are many reasons for non traumatic amputations in diabetics but
chief among them are the minor traumas that result in ulcerations and
poor wound healing. Soft tissue injuries can be caused, for example, by
the use of hot water bottles, walking barefoot, excessively short nails,
foreign objects shoes, tight shoes or socks, and corns and bunions [8].
Because the hospital stay of individuals newly
diagnosed with diabetes these days is brief, there is little time
available for them to get needed diabetes education. Nurses have to
squeeze foot care education into a program that covers the patient
monitoring his own blood glucose levels and other topics such as diet
and exercise. In addition, they have to conduct this education while
trying to get patients to understand how to deal with acute
complications such as hyperglycemia, ketoacidosis and hypoglycemia [9].
Therefore, given all that must be addressed in the education provided,
it is really quite difficult to stress selfcare behavior revolving
around foot care. All the different types of self-care required in
diabetes must be practiced daily [10].
Pointed out that these kinds of practices, which
require self-management skills, must be performed meticulously and
rigorously suggested that, given the limited amount of time available to
instructors providing diabetes education, foot care manuals are used in
general diabetes education [11].
A multidisciplinary team approach is needed to solve diabetic foot
problems. 50% of diabetes-related amputations could be prevented through
patient education and early diagnosis- treatment. Treatment makes up a
fundamental component of the education of the diabetic patient and is
crucial to improving his or her quality of life [12].
It is extremely important for diabetics to receive education on foot
care and diabetes in order to prevent the formation of foot wounds or to
detect them early. The nurse who is a member of the diabetes team is
the best person to plan protective care and to make sure that it is
carried out.
The diabetes nurse should be able to recognize the
complications that may occur in the feet of diabetic patients as well as
whether self-care is being practiced sufficiently. He or she should be
able to teach foot care behavior and monitor the individual's compliance
at intervals that correspond to the level of risk he has of developing
diabetic foot [13].
Foot care education should be provided individually and or with the
family. If possible, the knowledge the patient has of foot care and how
well he is able to take care of his feet should be checked at each
visit. It is essential that the diabetic have learned sound foot care
habits at the end of regularly provided education [14].
Structured and well organized education plays a vital
role in protecting the feet. The goal is increasing motivation and
skill. The patient is taught to recognize potential foot problems and
what he must do about them. The education should be provided in multiple
sessions over a period of time and a number of different methods should
be used. It is critical to make sure that the patient understands what
he is told that he is motivated and that he is sufficiently capable of
taking care of himself [15].
Conclusions
In conclusion, diabetic foot problems are preventable
complications. Preventive behaviors much be instilled in the diabetic
from the time he is diagnosed through regular monitoring and training.
Patient education and getting the patient to learn how to take care of
himself is extremely important in order to have him play an active role
in the successful treatment and monitoring of the disease. Problem free
foot care is cheaper than the treatment of diabetic foot problems.
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