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Maldonado-Valer T, Pareja-Mujica LF, Corcuera-Ciudad R, Terry-Escalante FA, Chevarría-Arriaga MJ, Vasquez-Hassinger T, Yovera-Aldana M. Prevalence of diabetic foot at risk of ulcer development and its components stratification according to the international working group on the diabetic foot (IWGDF): A systematic review with metanalysis. PLoS One 2023; 18:e0284054. [PMID: 38015974 PMCID: PMC10684108 DOI: 10.1371/journal.pone.0284054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/22/2023] [Indexed: 11/30/2023] Open
Abstract
AIMS To determine the overall prevalence of diabetic foot at risk according to the International Working Group on the Diabetic Foot stratification. MATERIALS AND METHODS We searched PubMed/Medline, Scopus, Web of Science, and Embase. We included cross-sectional studies or cohorts from 1999 to March 2022. We performed a meta-analysis of proportions using a random-effects model. We assessed heterogeneity through subgroup analysis by continent and other characteristics. RESULTS We included 36 studies with a total population of 11,850 people from 23 countries. The estimated overall prevalence of diabetic foot at risk was 53.2% (95% CI: 45.1-61.3), I2 = 98.7%, p < 0.001. In the analysis by subgroups, South and Central America had the highest prevalence and Africa the lowest. The factors explaining the heterogeneity were the presence of chronic kidney disease, diagnostic method for peripheral arterial disease, and quality. The estimates presented very low certainty of evidence. CONCLUSIONS The overall prevalence of diabetic foot at risk is high. The high heterogeneity between continents can be explained by methodological aspects and the type of population. However, using the same classification is necessary for standardization of the way of measuring the components, as well as better designed general population-based studies.
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Affiliation(s)
| | | | - Rodrigo Corcuera-Ciudad
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, CHANGE Research Working Group, Lima, Peru
| | - Fernando Andres Terry-Escalante
- Universidad de San Martín de Porres, Facultad de Medicina Humana. Lima, Peru
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Peru
| | | | | | - Marlon Yovera-Aldana
- Grupo de Investigación en Neurociencias, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru
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Silva HCDDAE, Acioli S, Fuly PDSC, Lins SMDSB, dos Santos JO, Querido DL, Camacho ACLF, de Menezes HF. ICNP® terminological subset for people with diabetic foot ulcer in primary health care. Rev Bras Enferm 2023; 76:e20220668. [PMID: 38018616 PMCID: PMC10680387 DOI: 10.1590/0034-7167-2022-0668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/12/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES to elaborate an ICNP® terminological subset for people with diabetic foot ulcers in Primary Health Care. METHODS this is a methodological study that followed five steps: 1) Identification of relevant terms for the patients through an integrative literature review and official documents in the area; 2) Mapping of terms identified with ICNP® terms; 3) Construction of statements of nursing diagnoses, outcomes and interventions; 4) Structuring of a terminological subset with the Self-Care Deficit Theory; and 5) Content validity of statements constructed with nurses from a programmatic area in Rio de Janeiro. RESULTS the subset developed is composed of 81 diagnoses/outcomes and 583 nursing interventions, organized into universal, change and development requirements. CONCLUSIONS the subset on screen was predominantly composed of statements inserted in self-care requirements related to health changes, reinforcing the importance of quality of life and recovery.
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Affiliation(s)
- Halene Cristina Dias de Armada e Silva
- Governo do Estado do Rio de Janeiro, Secretaria de Estado de Saúde. Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sonia Acioli
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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Rastreamento de risco de ulceração nos pés em participantes de campanhas de prevenção e detecção do diabetes mellitus. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao02867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Lima LJLD, Lopes MR, Botelho Filho CADL, Cecon RS. Avaliação do autocuidado com os pés entre pacientes portadores de diabetes melito. J Vasc Bras 2022; 21:e20210011. [PMID: 35251141 PMCID: PMC8862594 DOI: 10.1590/1677-5449.210011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background The diabetic foot is a complication of diabetes mellitus (DM) and is the most common cause of lower limb amputation. Objectives To assess foot self-care practices by sex and educational level in DM patients from the Northeast of Brazil, state of Bahia. Methods This was a quantitative, cross-sectional, observational, analytical study with 88 DM patients seen at routine consultations from February to March of 2020. Data were collected using questionnaires on socioeconomic data and self-care of feet (knowledge about the diabetic foot, habits related to care/inspection of feet, and visits to the Healthcare Center when changes to foot health are detected). Results 58% of the sample did not know the term “diabetic foot”, but a majority did perform minimum adequate foot care practices, such as inspecting feet (60.2%), moisturizing feet (65.9%), avoiding walking barefoot (81.8%), and trimming toenails (92%), although 90.9% did not wear footwear considered appropriate. There was a relationship between lower educational level and worse performance in questions relating to walking barefoot, moisturizing feet, trimming toenails, wearing appropriate footwear, and identifying mycoses (p < 0.05), but there was no association between performing self-care activities and sex. Conclusions Interviewed patients with DM did not perform all foot self-care activities and did not know what the term “diabetic foot” means. There was an association between lower educational level and reduced capacity to perform these activities, which suggests that health literacy is important to improve self-care of feet, contributing to reduce complications and foot amputations.
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Felix LG, Mendonça AEOD, Costa IKF, Oliveira SHDS, Almeida AMD, Soares MJGO. Knowledge of primary care nurses before and after educational intervention on diabetic foot. Rev Gaucha Enferm 2021; 42:e20200452. [PMID: 34878024 DOI: 10.1590/1983-1447.2021.20200452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/31/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To compare the knowledge of the nurses about the diabetic foot before and after the educational intervention. METHOD Quasi-experimental study, before-and-after type, carried out with 53 nurses, from March to June 2016, in the municipality of Campina Grande, Paraíba. The Questioning Methodology was used to develop the educational intervention. Knowledge was investigated using an instrument designed by the researchers. For data analysis before and after the intervention, the McNemar and Wilcoxon tests were performed. RESULTS The knowledge of the nurses about the diabetic foot turned out to be deficient, with a mean of correct answers in the pre-test of 23.8 (SD±12.8) and after 41.9 (SD±9,2), with a statistically significant difference (p<0.01). CONCLUSION It was verified a significant increase in the knowledge after the intervention, highlighting the items related to evaluate the loss of plantar protective sensitivity, essential for the prevention of diabetic foot.
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Affiliation(s)
- Lidiany Galdino Felix
- Universidade Federal de Campina Grande (UFCG), Centro de Ciências Biológicas e da Saúde, Unidade Acadêmica de Enfermagem. Campina Grande, Paraíba, Brasil
| | | | | | | | - Ana Maria de Almeida
- Universidade Federal da Paraíba (UFPB). João Pessoa, Paraíba, Brasil.,Universidade de São Paulo (USP), Escola de Enfermagem de Ribeirão Preto. Ribeirão Preto, São Paulo, Brasil
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Santiago MAMT, Tarcia RML, Frederico GA, Vitorino LM, Parisi MCR, Gamba MA. Digital educational technology for care management of diabetes mellitus people's feet. Rev Bras Enferm 2021; 74Suppl 5:e20190725. [PMID: 33787769 DOI: 10.1590/0034-7167-2019-0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 09/13/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to develop and validate a distance learning course aimed at the pillars of care management of diabetes mellitus people's feet. METHOD a technological production research using Moodle Virtual Learning Environment, based on Andragogy, Constructionism and Instructional Design. Content is based on consensus guidelines on diabetic foot. Validation was carried out by distance education, diabetes and/or diabetic foot experts. RESULTS the course's content is based on diabetic foot guidelines, and is structured in units with didactic material, videos, forums and questionnaires to assess the participants' learning. The judges considered it appropriate to meet nurses' needs in clinical practice. CONCLUSION the virtual learning course has been validated, being a promising strategy for training nurses on care management of diabetes mellitus people's feet.
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Brito JFP, Oliveira ACD, Sousa LSD, Silva EBD, Rocha ESB, Bezerra SMG. SENSORIMOTOR ALTERATIONS AND ASSOCIATED FACTORS IN DIABETES MELLITUS PATIENTS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2018-0508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to evaluate sensorimotor alterations in the extremities of the lower limbs and associated factors in Diabetes Mellitus patients. Method: this was a cross-sectional and analytical study, conducted in a Basic Health Unit, in Teresina (Brazil) with a sample of 102 participants between April and July 2018, by means of a semi-structured form. For the statistical analyses, the Pearson's chi-square and Fisher's exact tests were performed. Results: among the study participants, 99 (97.1%) presented alterations, 73 (71.6%) on the skin and 40 (39.2%) on nails. The sensorimotor examination identified 40 (39.22%) individuals with tactile sensitivity alterations and 13 (12.7%) with reduced vibratory sensitivity, using the 128 Hz tuning fork. The factors associated with sensorimotor alterations detected by the 10 gram monofilament were the following: time of disease over ten years; absence of periodic foot evaluation (p=0.003); impaired visual acuity (p=0.001); presence of pain or discomfort (p=0.003); pain worsening at night (p=0.008); moderate pain intensity (p=0.012) and relief at rest (p=0.015). Conclusion: sensory alterations in the lower limbs showed their relationship with some of the research variables, such as time of disease, foot evaluation, glycemic value, presence of pain or discomfort (worsening and relief shifts, and intensity), skin coloring and vibratory sensitivity evaluation with a tuning fork.
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Noronha JAF, Azevedo C, Moura CDC, Gusmão ECR, Cardoso ACLR, Chianca TCM. Altered touch perception and associated risk factors in individuals with diabetes mellitus. Rev Bras Enferm 2020; 73:e20190473. [DOI: 10.1590/0034-7167-2019-0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/17/2020] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To evaluate the prevalence of altered touch perception in the feet of individuals with diabetes mellitus and the associated risk factors. Method: Cross-sectional study with 224 individuals with diabetes mellitus conducted in an endocrinology clinic at a public hospital in Campina Grande, Paraíba. The evaluation used touch sensitivity and perception, and a descriptive and multivariate analysis with Poisson regression was performed. Results: We found the prevalence of altered touch perception to be 53.1%. The risk factors that had a significant and joint impact on its occurrence were: female gender; previous ulcer; diabetes mellitus type 2; burning sensation, cracks, fissures, calluses, and Charcot foot. Conclusions: This study found a high prevalence of altered perception of touch, and this should support the planning of actions aimed at preventing the problem. The study showed the relevance of the phenomenon as a nursing diagnosis that could be included in NANDA-International.
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