Sudomotor disfonksiyonu olan diyabetik hastalarda ayak bakım eğitimi etkinliğinin değerlendirilmesi

Year 2023, , 9 - 16, 30.01.2023

Emine Sevinç Postacı , Şule Alpar Ecevit

https://doi.org/10.55665/troiamedj.1160760

Abstract

Amaç: Araştırmada, ayak nem ölçümüyle sudomotor disfonksiyonu belirlenen diyabetik hastalarda verilen ayak bakım eğitiminin ayak sağlığı üzerine etkilerinin hastaların diyabet yönetimine ilişkin öz-etkililikleri ve diyabet hastalarında ayak bakım alışkanlıklarına etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Araştırmada, Çanakkale Onsekiz Mart Üniversitesi tıp fakültesi hastanesi endokrinoloji polikliniğine temmuz 2012- mart 2013 tarihlerinde başvuran 597 diyabet hastasından, amaçlı örneklem doğrultusunda vaka seçim kriterlerine uyan ve araştırmaya katılımda gönüllü olan 112 hasta değerlendirildi. Çalışma örneklemini oluşturan hastaların 59’una (deney grubu) eğitim verilirken, 53 kişiye (kontrol grubu) eğitim verilmedi. Deney grubundaki hastalara araştırmacı tarafından ayak bakım eğitimi verildi. Araştırma verileri için hasta bilgi formu, metabolik değişkenler formu, ayak değerlendirme formu, diyabet yönetimine ilişkin öz-etkililik ölçeği, diyabet hastalarında ayak bakım alışkanlığı formu kullanıldı. Veriler SPSS 16.0 paket programı kullanılarak karşılaştırma testleri ve tanımlayıcı istatistiksel yöntemlerle analiz edildi. Bulgular: Öz-etkililik ölçeği puan ortalamaları açısından araştırmanın başlangıcında ve sonundaki fark deney grubunda istatistiksel olarak anlamlı bulundu (p<0.01). Ayak bakım alışkanlığı formuna göre deney grubunda araştırma süresince olumlu alışkanlıklara verilen evet hayır yanıtları arasındaki fark istatistiksel olarak anlamlı bulundu (p<0.01). Sonuç: Sudomotor disfonksiyonu olan diyabetik hastalarda ayak bakım eğitiminin ayak sağlığı üzerine olumlu etkileri olduğu saptanmıştır.

Keywords

diabetes mellitus, sudomotor disfonksiyon, diyabetik ayak, hasta eğitimi

The evaluation of the foot care training event on diabetic patients with sudomotor dysfunction

Abstract

The evaluation of the foot care training event on diabetic patients with sudomotor dysfunction
Objectives: The aim of the study was to evaluate the effects of foot care training given in diabetic patients whose sudomotor dysfunction was determined by foot moisture measurement, on the effects of foot health on patients' self-efficacy on diabetes management and on foot care habits in diabetic patients. Methods: In the study, 112 patients who met the case selection criteria from 597 diabetic patients who applied to the Endocrinology outpatient clinic of Canakkale Onsekiz Mart University medical faculty hospital between july 2012 and march 2013 were evaluated. While training was given to 59 (experimental group) patients in the study sample, no training was given to 53 people (control group). The patients in the experimental group were given foot care training by the researcher. Patient information form, metabolic variables form, foot evaluation form, diabetes management self-efficacy scale, and foot care habits form in diabetes patients were used for research data. The data were analyzed using the SPSS 16.0 package program with comparison tests and descriptive statistical methods. Results: The difference in self-efficacy scale mean scores at the beginning and end of the study was statistically significant in the experimental group (p<0.01). According to the foot care habit form, the difference between yes and no responses to positive habits in the experimental group during the study was found to be statistically significant (p<0.01). Conclusion: It has been determined that foot care training has positive effects on foot health in diabetic patients with sudomotor dysfunction.

Keywords

diabetes mellitus, sudomotor dysfunction, diabetic foot, patient education, sudomotor disfonksiyon, diyabetik ayak, hasta eğitimi

References

• 1. Altundaş Y. Definition, Diagnosis and Classification of Diabetes Mellitus. Inside: Diabetes Mellitus in All Aspects. Ed: Yengün M., 2. Printing, Nobel Medical Bookstores, İstanbul 2001.
• 2. Diabetes Diagnosis and Treatment Guide. Turkey Diabetes Foundation, İstanbul 2011.
• 3. Durna Z. Classification of Diabetes and Diagnostic Criteria. Inside: Diabetes Nursing. Ed: Erdoğan S., Yüce Reklam Co., İstanbul 2002.
• 4. https://diabetesatlas.org/atlas/tenth-edition/ (erişim tarihi 03.08.2022)
• 5. Yeşil S. Diyabetik nöropati ve tedavisi. Turkiye Klinikleri J Endocrin. 2003;1(3):232-6
• 6. Feldman EL, Callaghan BC, Pop-Busui R, Zochodne DW, Wright DE, Bennett DL, et al. Diabetic neuropathy. Nature Reviews Disease Primers. 2019;5(1):41.
• 7. Kurşun O. The use of intraepidermal nerve fiber analysis in the diagnosis of distal neuropathy as a result of glucose metabolism disorders. Uzmanlık Tezi. Hacettepe Universitsi, Nöroloji Anabilim Dalı, Ankara. 2007.
• 8. Altındaş M. [Diabetic Foot]. Nobel Medical Bookstores;İstanbul 2002;1-26.
• 9. Yılmaz C, Yılmaz T, İmamoğlu Ş. Diabetes mellitus 2000;17-53;169-177.
• 10. Smith S, Normahani P, Lane T, Hohenschurz-Schmidt D, Oliver N, Davies AH. Prevention and Management Strategies for Diabetic Neuropathy. Life (Basel, Switzerland). 2022;12(8).
• 11. Papanas N, Paschos P, Papaoglou D, et al. Accuracy of the neuropad test for thediagnosis of distal symmetric polyneuropathy in type 2 diabetes. Diabetes Care 2011;34(6):1378-82.
• 12. CaselliniCM, ParsonHK, RichardsonMS, NevoretML, VinikAI.Sudoscan, a Non invasive tool for detecting diabetic small fiber neuropathy and autonomic dysfunction. DiabetesTechnolTher 2013;15:948–53.
• 13. Krieger SM, Reimann M, Haase R, Henkel E, Hanefeld M, Ziemssen T. Sudomotor Testing of Diabetes Polyneuropathy. Front Neurol. 2018. 26(9):803.
• 14. Çiçek D, Kandi B, Oğuz S, et al. Skin manifestations in patients with diabetes mellitus. Fırat Health Services Journal 2010;24(2):77-80.
• 15. Lim JZM, Ng NSL, Thomas C. Prevention and treatment of diabetic foot ulcers. Journal of the Royal Society of Medicine. 2017;110(3):104-9.
• 16. Efe B. Foot Problems of Diabetes Mellitus. Yenigün, M.(Edt.): Diabetes Mellitus in All Aspects (2. Printing); Nobel Medical Bookstores; L.L.C., İstanbul 2001.
• 17. Yılmaz T, Bahçeci M, Büyükbeşe A. Modern Treatment of Diabetes Mellitus. Özlem Graphic Printing;2003. 18. Yöntem A, Çakır B. Diabetic Outpatient Risk Factors and Prevention, Clinical Sciences and Doctors. 2002;294-303.
• 19. Fevzioğlu P. Efficacy of pulse electromagnetic field therapy in resistant diabetic neuropathic pain. Uzmanlık Tezi. Trakya Üniversitesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Edirne. 2008.
• 20. Yüksel A. Protection from diabetic foot wound: İ.Ü. Cerrahpaşa Medical Faculty Continuous Medical Education Activities, Wound Care and Treatment, Symposium Series, No:67, 2008; İstanbul, Turkey. 2008;101-105.
• 21. Efe B. Foot Problems of Diabetes Mellitus. Yenigün, M.(Edt.): Diabetes Mellitus in All Aspects (2. Printing); Nobel Medical Bookstores; L.L.C., İstanbul 2001; 513-30.
• 22. Batkın D, Çetinkaya F. Diabetes mellitus patients' foot care and knowledge, attitude and behavior about the diabetic foot. Health Sciences Magazine 2005;14(1):6-12.
• 23. Tentolouris N, Edmonds ME, Jude EB, Vas PRJ, Manu CA, Tentolouris A, et al. Editorial: Understanding Diabetic Foot Disease: Current Status and Emerging Treatment Approaches. 2021;12.
• 24. Dumville JC, Deshpande S, O'Meara S, Speak K. Hydrocolloid dressings for healing diabetic foot ulcers. The Cochrane database of systematic reviews. 2013;2013(8):Cd009099.
• 25. Kisozi T, Mutebi E, Kisekka M, Lhatoo S, Sajatovic M, Kaddumukasa M, Nakwagala FN, Katabira E. Prevalence, severity and factors associated with peripheral neuropathy among newly diagnosed diabetic patients attending Mulago hospital: a cross-sectional study. Afr Health Sci. 2017;17(2):463-473.
• 26. Ambreen A, Muhammad AH, Umar AK, et al. Reliability of the neurological scores for assessment of sensorimotor neuropathy in type 2 diabetics. J Pak Med Assoc. 2010;60(3):166-170.
• 27. Tentolouris N, Voulgari C, Liatis S, Kokkinos A, Eleftheriadou I, Makrilakis K, Marinou K, Katsilambros N. Moisture status of the skin of the feet assessed by the visual test neuropad correlates with foot ulceration in diabetes. Diabetes Care.2010;33(5):1112-14.
• 28. Jude EB, Boulton A. (2000). The Diabetic Foot. Diabetes; Current Perspectives. Betteridge, D.J.: Martın Dınıtz Ltd., First Published in the United Kingtom, s: 179-196.
• 29. Efe B.(2001). Diabetes Mellitus’un Ayak Problemleri. Yenigün, M.(Edt.): Her Yönüyle Diabetes Mellitus (2. Baskı); Nobel Tıp Kitap Evleri; Ltd. Şti., İstanbul s: 513-530.
• 30. Altındaş M.(2002). Diyabetik Ayak. Nobel Tıp Kitap Evleri, İstanbul.
• 31. Yüksel A. (2008). Diyabetik ayak yarasından korunma: İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri, Yara Bakımı ve Tedavisi, Sempozyum Dizisi, No:67, s. 101-105.
• 32. Yöntem A, Çakır B. (2002). Diyabetik Ayakta Risk Faktörleri ve Korunma, Klinik Bilimler ve Doktorlar. s: 294-303.
• 33. Yılmaz T, Bahçeci M, Büyükbeşe A. (2003). Diabetus Mellitus’un Modern Tedavisi. Özlem Grafik Matbaacılık, İstanbul.
• 34. Singh S, Jajoo S, Shukla S, Acharya S. Educating patients of diabetes mellitus for diabetic foot care. J Family Med Prim Care. 2020;9(1):367-373.
• 35. Al-Gaows, FS, Al-Zahrani AM. Knowledge and practice of foot care among diabetic patients attending diabetic care center in Jeddah City. Int J Med Rev Case Rep 2019;3(11):664-670.
• 36. Mohammed MAA, Rahman NAI. Knowledge, attitude, and practice of foot care among type 2 diabetic patients attending diabetic clinic Al Ribat Teaching Hospital in Sudanese patients. Advances in Diabetes and Metabolism 2018;6(3):34-53.
• 37. Desalu OO, Salawu FK, Jimoh AK. Diabetic foot care: Self reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J 2011;45(2):6065.
• 38. Alshammari ZJ, Alsaid LA, Parameaswari PJ, Alzahrani AA. Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia. Journal of family medicine and primary care. 2019;8(6):2089-94.
• 39. Fan L, Sidani S, Cooper-Brathwaite, A., Metcalfe, K. Improving foot self-care knowledge, self-efficacy, and behaviors in pilot patients with type 2 diabetes at low risk for foot ulceration: A Pilot Study. Clin Nurs Res 2013;23(6):1-17.
• 40. Sriram M, Doke P, Dasila P. Effectiveness of foot care education among people with Diabetes Mellitus in urban community, Mumbai. Int J Pharm Biol Sci 2018;13(2):1-4.
• 41. Bonner T, Foster M, Spears-Lanoix E. Type 2 diabetes–related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabetic Foot & Ankle. 2016;7(1):29758.
• 42. Grillo Mde F, Neumann CR, Scain SF, Rozeno RF, Beloli L, Perinetto T, et al. Diabetes education in primary care: a randomized clinical trial. Cadernos de saude publica. 2016;32(5).
• 43. Kır Bicer E, Enc N. Validity and Reliability of the Turkish Adaptation of the Foot Self Care Behavior Scale. Journal of Nursing Forum in Diabetes, Obesity and Hypertension 2014;6(2):35-39. Available from: http://www.tdhd.org/assets/ uploads/dergiler/2014-2_ANA_METIN.pdf.
• 44. Anastasi JK, Capili B, Chang M. HIV peripheral neuropathy and foot care management: A review of assessment and relevant guidelines 2013;113(12):34-40.
• 45. Celik S, Olgun N, Yilmaz FT, Anataca G, Ozsoy I, Ciftci N, et al. Assessment the effect of diabetes education on self-care behaviors and glycemic control in the Turkey Nursing Diabetes Education Evaluating Project (TURNUDEP): a multi-center study. BMC Nursing. 2022;21(1):215.
• 46. Mekonnen Y, Hussien N. Self-care Related Knowledge, Attitude, and Practice and Associated Factors Among Patients with Type 2 Diabetes in JMC, Ethiopia. Diabetes, metabolic syndrome and obesity : targets and therapy. 2021;14:535-46.
• 47. Tuha A, Getie Faris A, Andualem A, Ahmed Mohammed S. Knowledge and Practice on Diabetic Foot Self-Care and Associated Factors Among Diabetic Patients at Dessie Referral Hospital, Northeast Ethiopia: Mixed Method. Diabetes, metabolic syndrome and obesity : targets and therapy. 2021;14:1203-14.
• 48. Priyadarshini J, Abdi S, Metwaly A, Al- Lenjawi B, Jose J, Mohamed H. Prevention of Diabetic Foot Ulcers at Primary Care Level. Dermatology - Open Journal. 2018;3:4-9.
• 49. Bains SS, Egede LE. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low ıncome population with type 2 diabetes. Diabetes Technol Ther 2011;13(3):335-341.
• 50. Finfgeld DL, Wongvatunya S, Conn VS. Health belief model and reversal theory: A comparative analysis, JAN 2003;43(3):288297.
• 51. Skinner TC, Hampson SE. Personal models of diabetes in relation to self care, well being, and glycemic control. Diab Care 2001;24(5):828-833.
• 52. Marso SP, Hiatt WR. Peripheral Arterial Disease in Patients With Diabetes, Journal of the American College of Cardiology 2006; 47: 921-929.
• 53. Kaymaz Kocak, D, Olgun N. To Be Acquired of Foot Caring Skill to The Type 2 Diabetics, Journal of Nursing Forum in Diabetes, Obesity and Hypertension 2009;1(1):28-37.
• 54. Nemcová J, Hlinková E. The efficacy of diabetic foot care education. J Clin Nurs. 2014;23(5-6):877-82.
• 55. Rankin S, Stallings KD. Patient education in health and illness. 2005; Lippincott Williams & Wilkins.
• 56. Krivohlavy J. Psychologie nemoci -Psychology of disease. Praha, Grada 2002;47.
• 57. Petlak A., Komora, E. Vyučovanie v otázkach a odpovediach, 2003;98.