nach oben

International Journal of Diabetes in Developing Countries

Erschienen in:

06.07.2017 | Original Article

Preventing and managing diabetic foot ulcers: application of Orem’s self-care model

verfasst von: Masomeh Hemmati Maslakpak, Azam Shahbaz, Naser Parizad, Mansour Ghafourifard

Erschienen in: International Journal of Diabetes in Developing Countries | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

One of the most common complications of diabetes mellitus is a diabetic foot ulcer. Thus, managing and preventing this complication is a main priority for health professionals, especially for nurses. This study was designed to investigate the application of Orem’s self-care deficit theory on prevention and management of diabetic foot ulcer. This quasi-experimental study was conducted in Urmia, Iran. Purposive sampling was used to select 60 patients and they were allocated into two groups. Two patients in the intervention group were excluded due to amputation and four patients from each group left the study because of unwillingness to complete the study. The intervention group received two self-care training sessions and home visits for 12 weeks, but the control group received the routine care. Data were collected using a questionnaire which consisted of four parts (demographic data, self- care status, need assessments based on Orem model, and Saint Elian Wound Score System). Data were analyzed by SPSS software (ver. 16). A significant difference was found between two groups regarding self-care mean scores, number of affected zones, ischemia, infection, and wound healing phase (p < 0.05). Application of Orem’s self-care model could be helpful for the management of diabetic foot ulcers and could change patients’ lives by lowering the risk of amputation and medical costs.

Organization WH. Diabetes Mellitus. Fact Sheet N 138. 2012. Available at: http://www.who.int/mediacentre/factsheets/fs138/en/. Accessed 24 Feb 2015.

Hadadi A, Ghiasi HO, Hajiabdolbaghi M, Zandekarimi M, Hamidian R. Diabetic foot: infections and outcomes in Iranian admitted patients. Jundishapur J Microbiol. 2014;7(7). e11680. doi: 10.5812/jjm.11680 .

Sinwar PD. The diabetic foot management—recent advance. Int J Surg. 2015;15:27–30. doi:10.1016/j.ijsu.2015.01.023.CrossRefPubMed

Madanchi N, Tabatabaei-Malazy O, Pajouhi M, Heshmat R, Larijani B, Mohajeri-Tehrani M-R. Who are diabetic foot patients? A descriptive study on 873 patients. J Diabetes Metab Disord. 2013;12(1):36. doi:10.1186/2251-6581-12-36.CrossRefPubMedPubMedCentral

Paton J, Bruce G, Jones R, Stenhouse E. Effectiveness of insoles used for the prevention of ulceration in the neuropathic diabetic foot: a systematic review. J Diabetes Complicat. 2011;25(1):52–62. doi:10.1016/j.jdiacomp.2009.09.002.CrossRefPubMed

Margolis DJ, Malay DS, Hoffstad OJ, Leonard CE, MaCurdy T, De Nava KL et al. Incidence of diabetic foot ulcer and lower extremity amputation among Medicare beneficiaries, 2006 to 2008. 2011. Available at: https://www.ncbi.nlm.nih.gov/books/NBK65149/. Accessed 24 Feb 2015.

Yekta Z, Pourali R, Nezhadrahim R, Ravanyar L, Ghasemi-rad M. Clinical and behavioral factors associated with management outcome in hospitalized patients with diabetic foot ulcer. Diabetes Metab Syndr Obes. 2011;4:371. doi:10.2147/dmso.s25309.CrossRefPubMedPubMedCentral

Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputations in diabetes. Diabetes in America. 1995:409–27.

Hokkam EN. Assessment of risk factors in diabetic foot ulceration and their impact on the outcome of the disease. Prim Care Diabetes. 2009;3(4):219–24. doi:10.1016/j.pcd.2009.08.009.CrossRefPubMed

10.

Vedhara K, Dawe K, Wetherell MA, Miles JN, Cullum N, Dayan C, et al. Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: a prospective study. Diabetes Res Clin Pract. 2014;106(1):67–72. doi:10.1016/j.diabres.2014.07.018.CrossRefPubMed

11.

Ghafourifard M, Ebrahimi H. The effect of Orem’s self-care model-based training on self-care agency in diabetic patients. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2015;23(1):5–13.

12.

Landim CA, Zanetti ML, Santos MA, Andrade TA, Teixeira CR. Self-care competence in the case of Brazilian patients with diabetes mellitus in a multiprofessional educational programme. J Clin Nurs. 2011;20(23–24):3394–403. doi:10.1111/j.1365-2702.2011.03883.x.CrossRefPubMed

13.

Norris SL, Engelgau MM, Narayan KV. Effectiveness of self-management training in type 2 diabetes a systematic review of randomized controlled trials. Diabetes Care. 2001;24(3):561–87. doi:10.2337/diacare.24.3.561.CrossRefPubMed

14.

Chin Y-F, Liang J, Wang W-S, Hsu BR-S, Huang T-T. The role of foot self-care behavior on developing foot ulcers in diabetic patients with peripheral neuropathy: a prospective study. Int J Nurs Stud. 2014;51(12):1568–74. doi:10.1016/j.ijnurstu.2014.05.001.CrossRefPubMed

15.

Orem D. Nursing concepts of practice. 6th ed. Mosby/Elsevier: St. Louis, MO; 2001.

16.

Taylor SG, Orem DE. Orem’s self-care deficit theory in nursing practice. In: Tomey AM AM, editor. Nursing theorists and their work. 6th ed.: St. Louis, MO. : Mosby/Elsevier; 2006.

17.

Association AD. Diagnosis and classification of diabetes mellitus. Diabetes care. 2013;36(Supplement 1):S62-S9. doi: 10.2337/dc14-s081.

18.

Adib-Hajbaghery M, Alinaghipoor T. The effects of lecture and multimodal methods of teaching on healing rate of diabetic foot ulcer and patients’ compliance with care recommendations. I J N. 2012;25(77):1–11.

19.

Huang Y, Xie T, Cao Y, Wu M, Yu L, Lu S, et al. Comparison of two classification systems in predicting the outcome of diabetic foot ulcers: the Wagner grade and the Saint Elian Wound Score Systems. Wound Repair Regen. 2015;23(3):379–85. doi:10.1111/wrr.12289.CrossRefPubMed

20.

Liniger C, Albeanu A, Bloise D, Assal JP. The tuning fork revisited. Diabet Med. 1990;7(10):859–64.CrossRefPubMed

21.

Herdman TH, editor. NANDA International Nursing Diagnoses 2012–14: definitions and classification. 9th ed. Oxford: Wiley-Blackwell; 2012.

22.

Fawcett J, Desanto-Madeya S. Contemporary nursing knowledge: analysis and evaluation of nursing models and theories. 3rd ed. Philadelphia, PA: FA Davis Company; 2012.

23.

Rubin RR, Peyrot M, Saudek CD. Differential effect of diabetes education on self-regulation and life-style behaviors. Diabetes Care. 1991;14(4):335–7. doi:10.2337/diacare.14.4.335.CrossRefPubMed

24.

Naji H, Nikhbakht Nasrabadi A, Shaban M, Saebnia R. The effect of using Orem’s model of self-care on recovery of patients with heart failure. Iran J Nurs Midwifery Res. 2009;14(4):174–9.

25.

Apelqvist J, Elgzyri T, Larsson J, Löndahl M, Nyberg P, Thörne J. Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients. J Vasc Surg. 2011;53(6):1582–1588. e2. doi: 10.1016/j.jvs.2011.02.006.

26.

Parisi MCR, Zantut-Wittmann DE, Pavin EJ, Machado H, Nery M, Jeffcoate WJ. Comparison of three systems of classification in predicting the outcome of diabetic foot ulcers in a Brazilian population. Eur J Endocrinol. 2008;159(4):417–22. doi:10.1530/eje-07-0841.CrossRefPubMed

27.

Gürlek A, Bayraktar M, Savaş C, Gedik O. Amputation rate in 147 Turkish patients with diabetic foot: the Hacettepe University Hospital experience. Exp Clin Endocrinol Diabetes. 1998;106(5):404–9. doi:10.1055/s-0029-1212006.CrossRefPubMed

28.

Prompers L, Schaper N, Apelqvist J, Edmonds M, Jude E, Mauricio D, et al. Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study Diabetologia. 2008;51(5):747–55. doi:10.1007/s00125-008-0940-0.CrossRefPubMed

29.

Islam S, Harnarayan P, Cawich S, Mahabir V, Budhooram S, Bheem V, et al. Secondary prevention of diabetic foot infections in a Caribbean nation a call for improved patient education. Int J Low Extrem Wounds. 2013;12(3):234–8. doi:10.1177/1534734613486151.CrossRefPubMed

30.

Chiovetti A. Bridging the gap between health literacy and patient education for people with multiple sclerosis. J Neurosci Nurs. 2006;38(5):374–8. doi:10.1097/01376517-200610000-00009.CrossRefPubMed

31.

Ren M, Yang C, Lin DZ, Xiao HS, Mai LF, Guo YC, et al. Effect of intensive nursing education on the prevention of diabetic foot ulceration among patients with high-risk diabetic foot: a follow-up analysis. Diabetes Technol Ther. 2014;16(9):576–81. doi:10.1089/dia.2014.0004.CrossRefPubMedPubMedCentral

32.

Horswell RL, Birke JA, Patout CA. A staged management diabetes foot program versus standard care: a 1-year cost and utilization comparison in a state public hospital system. Arch Phys Med Rehabil. 2003;84(12):1743–6. doi:10.1016/s0003-9993(03)00477-5.CrossRefPubMed

33.

Chiang HC, Liu YF, Chang SH. Applying Orem’s theory to the care of a diabetes patient with a foot ulcer. Tzu Chi Nursing Journal. 2007;6(6):127–35.

34.

Bakker K, Apelqvist J, Schaper NC. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes Metab Res Rev. 2012;28(S1):225–31. doi:10.1002/dmrr.2253.CrossRefPubMed

Titel: Preventing and managing diabetic foot ulcers: application of Orem’s self-care model
verfasst von: Masomeh Hemmati Maslakpak
Azam Shahbaz
Naser Parizad
Mansour Ghafourifard
Publikationsdatum: 06.07.2017
Verlag: Springer India
Erschienen in: International Journal of Diabetes in Developing Countries / Ausgabe 2/2018
Print ISSN: 0973-3930
Elektronische ISSN: 1998-3832
DOI: https://doi.org/10.1007/s13410-017-0570-5

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2018

Prevalence and risk factors of cognitive dysfunction in patients with type 2 diabetes mellitus receiving care in a reference hospital in Cameroon: a cross-sectional study

How good is procalcitonin as a marker in case of sepsis in diabetes mellitus?

The protective effect of the Pro12Ala polymorphism of peroxisome proliferator-activated receptor γ (PPARγ) isoform 2 in progression to diabetes in a Pakistani cohort

Dicer expression is impaired in diabetic cutaneous wound healing

Effect of vitamin D supplementation on reduction of cardiometabolic risk in patients with type 2 diabetes mellitus and dyslipidemia

Fibrocalculous pancreatic diabetes—current scenario in developing countries