Knowledge of diabetic foot care management among medical students at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Research hotspots and trends in nursing for diabetic foot ulcers: A bibliometric analysis from 2013 to 2023

Background

Nursing can effectively prevent and ameliorate diabetic foot ulcers (DFU). However, there is a lack of literature on the bibliometric analysis of DFU nursing. This study aimed to analyze the research hotspots and development trends in DFU nursing over the past 10 years to provide references for future related research.

Methods

The Web of Science Core Collection was used to retrieve literature related to DFU nursing from 2013 to 2023. Analyses included the annual publication trends; author, institution, and country collaborations; journal and literature co-citation; and keyword co-occurrence, clustering, and bursting, performed using CiteSpace 5.8 R3.

Results

A total of 229 papers were included, showing an upward trend in annual publications. American scholar David G Armstrong (n = 3) and King's College Hospital London (n = 4) were the most productive authors and institutions, respectively. The United States ranked first (n = 45) in national contributions, followed by China and Brazil. The overall research strength between authors and institutions was relatively scattered, and intensive cooperation has not yet been formed. National collaborations resulted in a core team dominated by Europe and North America with concentrated research strengths. The most frequently co-cited journal and co-cited reference were Diabetes Care (111 citations) and Armstrong DG (2017) (131 citations), separately. Research hotspots mainly focused on risk assessment, classification systems, protective measures, and clinical management of DFU. "Primary care" and "intervention efficacy" were identified as the research trends in the coming years.

Conclusion

The field of DFU nursing requires more attention. Academic exchange and cooperation between authors, institutions, and countries should be strengthened. Our future research will focus on the latest hotspots and trends, conducting more in-depth and comprehensive studies on DFU management.

Diabetic Foot Care: A Screening on Primary Care Providers' Attitude and Practice in Riyadh, Saudi Arabia

Background and Objectives: Diabetic foot (DF) disease is one of the myriad complications of diabetes. Positive outcomes are expected through a multidisciplinary approach as provided by primary care providers (PCPs). This study aimed to assess the knowledge of DF and attitude of physicians in primary healthcare settings toward DF diagnosis and prevention in Saudi Arabia. Materials and Methods: This observational cross-sectional study used a self-administered questionnaire that was completed by family medicine consultants, residents, and general practitioners working in primary care settings in Riyadh. Results: Of the 152 physicians who completed the survey, (43.4%) completed more than 10 h of diabetes continuing medical education (CME) over the past three years. Most (96.1%) PCPs educate patients about foot self-inspection, and only (64.5%) perform foot inspection at every visit in high-risk diabetic foot patients. PCP knowledge about diagnosing and managing diabetic foot infection was suboptimal. Only 53.9% of participants reported performing a probe-to-bone in DF patients with open wounds. Conclusions: We identified knowledge and action gaps among PCPs. Physicians had acceptable knowledge about preventive measures. However, deficits were found regarding diagnosing and management of DF infections. We recommend addressing these knowledge gaps by incorporating DF lectures and workshops within family medicine conferences and residency programs.

Assessment of nursing and midwifery students’ knowledge of treatment of diabetic foot syndrome using Lucilia servicata larvae

Background. Diabetes mellitus is one of the most common chronic diseases, and in recent years its prevalence has been systematically increasing. Untreated or ineffectively treated diabetes leads to the development of many complications. Among these that can significantly affect the quality of life is diabetic foot syndrome (DFS). Larvotherapy is a therapeutic method of treating wounds arising during the course of DFS. Aim of the study. The main objective of this study was to assess the level of knowledge of nursing and midwifery students on the treatment of DFS using Lucilia sericata larvae. Material and Methods. This study is a cross-sectional, observational study in which 202 nursing and midwifery students of Opole University were surveyed. The study was conducted online between June and November 2020, using a questionnaire developed by the authors. Results. The analysis showed considerable variation in the level of students' knowledge of treatment techniques for DFS. Those with the highest level of knowledge represented 39.15% (n=79), the average level of knowledge was represented by 28.2% (n=57), and the lowest level of knowledge was represented by 32.7% (n=66) of students. Regarding biosurgery in general, the highest level of knowledge about biosurgery was represented by 48.0% (n=97) of students. Nursing students had a higher level of knowledge than midwifery students regarding DFS treatment methods (p=0.001). There was no difference in the level of knowledge about biosurgery between nursing and midwifery students (p=0.503). Conclusions. The research presented in this study indicates that nursing and midwifery students have insufficient knowledge of DFS treatment methods and biosurgery. Nursing students are more likely than midwifery students to derive knowledge of DFS treatment methods from their studies and the literature. Education on treatment methods and techniques for DFS should be increased among students. Students' knowledge can be increased by classes in the course of their education and meetings with professionals.

Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: A cross-sectional study

BACKGROUND

Diabetes mellitus is a major public health issue and is the main cause of morbidity and mortality worldwide. At the time of diagnosis, many patients with type 2 diabetes (T2D) have one or two risk factors for diabetic foot diseases, such as diabetic peripheral neuropathy (DPN) and diabetic foot ulcers (DFUs). Patients can overcome such complications through good knowledge and practice of foot self-care. This study aims to evaluate the knowledge and practice of foot care among patients with diabetes mellitus attending primary healthcare centres (PHCs) in Kuwait and to identify those at risk for developing DPN.

METHODS

A cross-sectional study was conducted using a pre-tested self-administered questionnaire. The questionnaire included questions on demographic characteristics and patients' knowledge and practices of foot care. Adult patients (aged 21 and above) with a diagnosis of diabetes mellitus for at least 1 year were randomly selected from PHCs located in the five governorates of Kuwait. Data were analysed using SPSS, version 26.

RESULTS

A total of 357 patients participated in this study, giving a response rate of 87.3%. The overall mean knowledge score of foot care was 12.7 ± 2.7 (equals 81.3%). Most patients (n = 283, 79.3%) showed good knowledge. In comparison, less than one-third of patients (n = 110, 30.8%) practiced good foot care. The overall mean score of patients' practices was 55.7 ± 9.2 (equals 64.0%). Approximately 17.4% of the patients had a higher risk of developing DPN. University students had lower odds of having good knowledge about foot care [OR: 0.19 (95%CI: 0.04-0.86)]. On the other hand, patients who reported having diabetes for a long duration (10 years and above) [OR: 1.88 (95%CI: 1.11-3.18)] and patients who did not have any other comorbidities [OR: 0.49 (95%CI: 0.26-0.90)] had higher odds of having good foot care knowledge. Patients who were on oral hypoglycaemic agents (OHAs) only had lower odds [OR: 0.63 (95%CI: 0.39-1.00)] of practicing good foot care. Patients who reported having diabetes for a duration between 5 to less than 10 years [OR: 1.75 (95%CI: 1.06-2.90)] and those who are on a diet only [OR: 1.76 (95%CI: 1.06-2.94)] had higher odds of practicing good foot care. Patients who were using combination therapy with OHAs and insulin had a higher risk [OR: 2.67 (95%CI: 1.11-6.41)] of developing DPN. On the other hand, patients who reported that they did not have a previous history of foot ulcer had a lower risk of developing DPN [OR: 0.21 (95%CI: 0.09-0.47)].

CONCLUSION

The knowledge of patients with diabetes regarding foot care is rated as good, while their self-practice is considered satisfactory. To improve the foot care knowledge and self-care practice of patients, healthcare providers (HCPs) need to support patients through educational programmes and appropriate training.