The Diabetic Foot Assessment

Johnson, Rachel; Osbourne, Abe; Rispoli, Jessica; Verdin, Craig

doi:10.1097/nor.0000000000000414

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…Assessment of DFU focuses on four aspects as follows: vascular adequacy, neurological, sensory condition, suitability of footwear and presentation of foot malformation . As such, the critical attributes of the assessment phase are history and physical examination ; assessment of disease experience ; blood glucose levels and diabetic foot complications ; assessment for loss of protective sensation and risk classification ; utilising the 60‐second wound assessment tool ; performing clinical assessment including smoking history, nutritional status, total cholesterol level, exercise pattern, HbA1c and blood pressure ; and examining vascular adequacy, neurological or sensory condition, suitability of footwear along with presentation of foot malformation .…”

Section: Resultsmentioning

confidence: 99%

“…Such DFU interventions with the goal of diminishing complexities were also varied in the nursing literature such as history and physical examination, foot care education and referrals to wound care specialist if required. Foot assessment is highly recommended annually for patients presenting several risk factors contributing to ulceration recurrence, PAD and peripheral neuropathy . During the assessment, nurses must take into account a patient's illness history, examine the patient physically, assess for loss of protective sensation and risk classification .…”

Section: Resultsmentioning

confidence: 99%

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Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

Subrata

Phuphaibul

2019

Scandinavian Caring Sciences

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Background Diabetic foot ulcer care demonstrates a beneficial approach to overcoming problems in patients with diabetes. This approach is frequently given but is not always successfully implemented due to its fragmentation amid healthcare providers. What's more, there are a number of different understandings, interchangeable languages and an absence of uniformity overlapping terminologies of meaning for diabetic foot ulcer care. Therefore, analysing the concept of diabetic foot ulcer care is important to provide a wider nursing knowledge, synthesise a greater theoretical model and drive more effective care of diabetic foot ulcer. Objective This article aimed to analyse how the concept of diabetic foot ulcer care is clearly defined in the relevant evidence as it has several implications in nursing practice. Method Walker and Avant's (1995) method of concept analysis was systematically used in this study. Findings Three critical attributes of diabetic foot ulcer care were determined consisting of assessment, intervention and evaluation. Constructed cases are also presented to differentiate the concept of diabetic foot ulcer care from other concepts. This concept analysis results in the critical attributes of diabetic foot ulcer care, defines an operational definition and describes common goals that improve clarity, consistency and understanding of the concept amid healthcare professionals along with researchers. Conclusion Effective implementation of the concept of DFU care into clinical nursing practice may undoubtedly improve patient outcomes and prevent the complexities of DFU in the years to come. Future research needs to be developed for evaluating the current use of this concept.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

Subrata

Phuphaibul

2019

Scandinavian Caring Sciences

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“…Clinical data includes demographic information, diabetic duration, body mass index, smoking history, hypertension history, hyperlipidemia history and whether they are affected by diabetic complications. Diabetic complications, including diabetic foot, diabetic retinopathy, diabetic nephropathy and peripheral vascular disease in type 2 diabetes mellitus, were diagnosed by physicians according to the criteria defined in the relevant guidelines 18 , 31 , 32 , 33 , 34 , 35 . Laboratory data include HbA1c, fasting plasma glucose, triglyceride, total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, PLT, PCT, mean platelet volume (MPV), platelet distribution width standard deviation value (PDW‐SD) and platelet larger cell ratio.…”

Section: Methodsmentioning

confidence: 99%

Association of platelet count and plateletcrit with nerve conduction function and peripheral neuropathy in patients with type 2 diabetes mellitus

Qian

Zeng

Lin

et al. 2021

J of Diabetes Invest

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Aims/Introduction Diabetes has been considered as a ‘pro‐thrombotic state’ with enhanced platelet reactivity. Abnormality in platelet aggregation has been found in patients with its most common chronic complication – diabetic peripheral neuropathy (DPN). The purpose of this study was to investigate the potential association of platelet indices with nerve conduction function and the presence of DPN in Chinese patients with type 2 diabetes mellitus. Materials and Methods This study involved a total of 211 inpatients with type 2 diabetes mellitus and 55 healthy individuals for whom nerve conduction studies were carried out. DPN was diagnosed according to the American Diabetes Association recommendation. Clinical data were retrospectively collected. Results Patients with diabetes in whom neuropathy developed had lower levels of platelet count (PLT) and plateletcrit (PCT) than healthy controls (P < 0.05). Statistically significant associations of low PLT and PCT levels with the reduction of summed amplitude/velocity Z‐score, and the prolongation of F‐wave minimum latency in nerve conduction studies were found. Furthermore, after multivariate adjustment, logistic regression analysis showed that low levels of PLT (odds ratio 2.268, 95% confidence interval 1.072–4.797; P < 0.05; PLT <226 vs PLT ≥226) and PCT (odds ratio 2.050, 95% confidence interval 1.001–4.201; P < 0.05; PCT <0.222 vs PCT ≥0.222) in type 2 diabetes mellitus patients were risk factors for the presence of DPN. Conclusions Lower PLT and PCT levels are closely associated with poorer peripheral nerve conduction functions and the presence of neuropathy in patients with type 2 diabetes mellitus, which suggests that PLT and PCT might be potential biomarkers for showing DPN.

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“…For instance, an analysis of SOLVD (Studies of Left Ventricular Dysfunction) showed that jugular venous distention (JVD) and a third heart sound (S3) were independently associated with progression of heart failure [24]. For patients with diabetes, several of diabetic foot ulceration risk factors (included neuropathy, foot deformity, minor trauma, previous ulceration or amputation) are evaluated during a complete lower extremity examination [25]. Therefore, as more patients with chronic diseases turn to community for long-term management, careful PE on a regular basis is one of the easiest, least expensive and most effective measures for preventing complications.…”

Section: Comparisons With Existing Literaturementioning

confidence: 99%

Physical examination performed by general practitioners in 5 community health service institutions in Beijing: an observational study

Wei

Wang

Pan

et al. 2021

Preprint

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BackgroundPhysical examination is a central part of consultation. Evidence showed that clinical use of physical examination in hospital has decreased, but little is known about physical examination performed by general practitioners in community health service institutions.ObjectiveThis study aimed to investigate general practitioners’ performance of physical examination in community health service institutions in Beijing.MethodsAn observational study was conducted in 5 community health service institutions in Beijing, China between November 2019 and January 2020. And 11 participated general practitioners were observed for one workday. Information was recorded including patient characteristics, patient reasons for encounter, physical examinations provided by general practitioners, the length of consultation and time spent on specific activities in consultations.ResultsA total of 682 consultations were recorded from 11 general practitioners. Physical examination occurred in 15.8% of the consultations. Among the recorded 126 examinations, most were distributed in “Head, face, and neck examination” (n = 54, 42.9%) and “Cardiovascular examination” (n = 55, 43.7%), and no physical examination was performed on skin, male genitalia, female breasts and genitalia, and neurological systems. A total of 2823 minutes of activities were recorded. general practitioners only spent 3.1% of their time on physical examination, less than the time spent on taking history (18.2%), test (4.9%), diagnosis (22.7%), therapy (38.4%), and health education (8.6%). The mean length of time spent on physical examination portions was 0.8 ± 0.4 minutes.ConclusionPhysical examination was infrequently performed by general practitioners in community health service institutions in Beijing. More time and attention were needed for general practitioners performing a careful and appropriate physical examination in primary care.

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The Diabetic Foot Assessment

Cited by 17 publications

References 14 publications

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

Association of platelet count and plateletcrit with nerve conduction function and peripheral neuropathy in patients with type 2 diabetes mellitus

Physical examination performed by general practitioners in 5 community health service institutions in Beijing: an observational study

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