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The effectiveness of educational practice in diabetic foot: a view from Brazil

机译:糖尿病足教育实践的有效性:巴西的观点

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Background The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score ≤5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.
机译:背景技术本研究的目的是评估患有足溃疡风险,无前发发作,参加常规探访和服务提供的标准化教育并接受处方鞋的糖尿病受试者的预防和自我检查行为。这项评估是使用问卷调查(0-10分)进行的(高分反映了较差的实践依从性)。结果研究了60例患者(每种性别30例);平均年龄为62岁,平均病程为17年。至于合规性,有90%的人的总分≤5,只有8.7%的人定期穿上所提供的鞋子;自我足部检查占65%,其他熟悉的检查占28.3%;面霜77%;适当洗涤和干燥88%;正确剪除脚趾甲83%;无角质层切割83%;日常鞋子检查77%;不得使用浮石或类似的研磨剂70%;没有赤脚走路95%。结论:有计划的,多学科的教育方法可以使患有并发症风险的糖尿病患者对溃疡的预防护理高度合规。相反,观察到的使用所提供鞋类的合规性极低,这表明应进一步谨慎处理其可接受性问题。在巴西这样规模如此之大的国家,可以并且应该根据当地实际情况,通过为有患并发症风险的足部患者提供护理的服务来开展多学科教育。此外,每个教育计划都应通过使用适当的评估系统来评估目标人群的学习,获得的结果和功效。

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