Diabetes and infected foot ulcer: a survey of patients’ perceptions of care during the preoperative and postoperative periods

Mehica, Lejla; Gershater, Magdalena Annersten; Roijer, Carin Alm

doi:10.1002/edn.235

Cited by 4 publications

(7 citation statements)

References 72 publications

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“…24 It has been argued that a long healing time for auto-amputation will lead to increased suffering and pain. 21 However, in this study, the healing time was not significantly shorter for the participants who underwent minor surgical amputation.…”

Section: Discussioncontrasting

confidence: 60%

“…The participants were treated as outpatients, but in the case of vascular surgery, deep infection associated with septic condition, foot surgery, amputations or exacerbation of inter-current disease, they were treated as in-patients under the supervision of the multidisciplinary diabetic foot team. 2 , 6 , 15 , 21 , 22 Topical treatments were prescribed in a written form by the team, and dressing changes were performed under the supervision of a registered nurse in primary healthcare centres or home nursing services. Individually adjusted off-loading equipment was offered to all the participants.…”

Section: Methodsmentioning

confidence: 99%

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Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

et al. 2021

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Background: Forefoot gangrene in patients with diabetes is a severe form of foot ulcers with risk of progress and major amputation. No large cohort studies have examined clinical characteristics and outcome of forefoot gangrene in patients with diabetes. The aim was to examine clinical characteristics and outcome of forefoot gangrene in patients with diabetes admitted to a diabetic foot centre. Methods: Patients with diabetes and foot ulcer consecutively presenting were included if they had forefoot gangrene (Wagner grade 4) at initial visit or developed forefoot gangrene during follow-up at diabetic foot centre. Patients were prospectively followed up until final outcome, either healing or death. The median follow-up period until healing was 41 (3–234) weeks. Results: Four hundred and seventy-six patients were included. The median age was 73 (35–95) years and 63% were males. Of the patients, 82% had cardiovascular disease and 16% had diabetic nephropathy. Vascular intervention was performed in 64%. Fifty-one patients (17% of surviving patients) healed after auto-amputation, 150 after minor amputation (48% of surviving patients), 103 had major amputation (33% of surviving patients) and 162 patients deceased unhealed. Ten patients were lost at follow-up. The median time to healing for all surviving patients was 41 (3–234) weeks; for auto-amputated, 48 (10–228) weeks; for minor amputated, 48 (6–234) weeks; and for major amputation, 32 (3–116) weeks. Conclusion: Healing without major amputation is possible in a large proportion of patients with diabetes and forefoot gangrene, despite these patients being elderly and with extensive co-morbidity.

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Section: Discussioncontrasting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

et al. 2021

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“…One of them, the Quality from the Patient’s Perspective questionnaire (QPP)13 and its short version,14 allows the patient to complete an evaluation of the quality of care via a self-administered validated questionnaire. The Mini QPP was also previously used in a study with patients from Sweden with diabetes and with an infected DFU that required a toe or forefoot amputation 29…”

Section: Methodsmentioning

confidence: 99%

“…The Mini QPP was also previously used in a study with patients from Sweden with diabetes and with an infected DFU that required a toe or forefoot amputation. 29 The short French form of the QPP questionnaire was selected to assess patients' perceptions of care as it has already been used in previous research with French-speaking patients. 16 The internal reliability (measured as Cronbach's α values) ranged between 0.64 and 0.85 on dimensions of the short form version of this questionnaire.…”

Section: Instruments and Outcome Measuresmentioning

confidence: 99%

Treatment of Diabetic Foot Ulcers Based on an Interdisciplinary Team Approach

Patry,

Bourgault,

Blanchette

2024

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: The purpose of this study was to evaluate patients’ perception and quality of diabetic foot ulcer (DFU) care delivered by an interdisciplinary team approach (ITA). DESIGN: Exploratory cross-sectional study. SUBJECTS AND SETTING: Twenty patients with a healed plantar DFU were recruited from an interdisciplinary Wound Care clinic of a Canadian University affiliated hospital. Their mean age was 64 years (75% were males [n = 15]), 18 (90%) were living with type 2 diabetes, and 45% (n = 9) had osteomyelitis in the previous year of their enrollment in the study. METHODS: The validated short form of the Quality From the Patient’s Perspective questionnaire was used to evaluate quality of care dimensions (medical-technical competence of the caregivers; physical-technical conditions of the care organization; degree of identity-orientation in the attitudes and actions of the caregivers; and sociocultural atmosphere of the care organization). RESULTS: Respondents reported experiencing a high level of quality care with an ITA. All indicators of patient-perceived reality of care delivered were superior or equal related to their subjective importance in all dimensions of quality care (with scores ranging from 3.85 to 4.00 on a 4-Point Likert scale). Patients’ satisfaction regarding the ITA was high. CONCLUSIONS: Study findings suggest that an ITA model provided high quality of care for treating DFUs for all quality dimensions judged important for patients.

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“…To the best of our knowledge, there are no studies on the effect of changes in self‐care skills or nursing needs on outcome of DFU or risk of their recurrence. A previous study about nursing for people with diabetes who had been treated in hospital for infected DFUs revealed that patients asked for more information, more engagement in the decisions about their health, a physical environment adjusted to reduced mobility and morbidity and increased pain relief (Mehica et al., 2013). Requirements to maintain self‐care activities after minor amputation, treatment for deep infection and endovascular intervention have not been described.…”

Section: Introductionmentioning

confidence: 99%

Changes in daily nursing needs and self‐care capability of people with diabetes after in‐hospital treatment for foot complications: A descriptive study

Annersten Gershater,

Zdravkovic,

Elgzyri

2024

Nursing Open

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AimA limited number of studies discuss the changes in patients' self‐care skills and needs for assisted self‐care after discharge from in‐patient treatment due to diabetes foot ulcer‐related complications. The aim of this study was to examine the ability to perform self‐care and needs for assisted nursing interventions at hospital discharge, compared to pre‐admission, for people with diabetes admitted and treated for foot ulcer‐related complications.DesignRetrospective patient record study.MethodsA retrospective assessment was done on the medical records of a total of 134 patients with diabetes consecutively admitted to a specialist in‐patient unit due to foot ulcer complications, between 1 November 2017 and 30 August 2018. Data on daily self‐care needs and home situations at admission and discharge were recorded.ResultsThe median age was 72 years (38–94), 103 (76.9%) were men and 101 (73.7%) had diabetes type 2. The median length of admission was 10 days (2–39). Infection was the most common cause of admission (51%), with severe ischaemia in 6%, and a combination of both in 20% of patients. Surgical treatment was performed in 22% and vascular intervention in 19% of patients. The percentage of patients discharged to their home without assistance was 48.1% compared to 57.5% before admission, discharge to home with assistance was 27.4% versus 22.4% before admission and 9.2% were discharged to short‐term nursing accommodation versus 6% before admission. Three patients died during their stay in hospital. The need for help with medications increased from 14.9% of patients at admission to 26.7% at discharge and for mobility assistance from 23.1% to 35.9%. Social services at home were increased in 21.4% of patients at discharge.

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Diabetes and infected foot ulcer: a survey of patients’ perceptions of care during the preoperative and postoperative periods

Abstract: Persönliches: Frank‐Ulrich Drexler 60 Jahre Nachrichten: Ingenieurpreis 2015 verliehen / Bau des Betongartens BUGA 2015 abgeschlossen / VDI setzt auf Digitalisierung der Baubranche Zuschriften zu: Stefan Polónyi: Zuviel Stahl im Beton? DOI:

Cited by 4 publications

References 72 publications

Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene

Treatment of Diabetic Foot Ulcers Based on an Interdisciplinary Team Approach

Changes in daily nursing needs and self‐care capability of people with diabetes after in‐hospital treatment for foot complications: A descriptive study

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