Effect of nurse‐led care on quality of care and level of HbA1C in patients with diabetic foot ulcer: A randomized clinical trial

摘要

Abstract Diabetic foot ulcer (DFU) is a serious and costly complication in diabetes which affects different aspects of life and can reduce patient's quality of life. Various views to manage DFU have been introduced. The nurse‐led team, as a multidisciplinary team, can be effective due to a holistic approach to some disease management; but in patients with DFU it has not been assessed. Therefore, this study was designed to determine the effect of nurse‐led care on quality of care (QOC) and improvement of HbA1C in Patients with DFU. This was a randomized clinical trial study performed on 52 patients with DFU. Patients were randomly assigned into two groups: nurse‐led care intervention and standard care. The study was conducted in one of the hospitals affiliated to Tehran University of Medical Sciences. Data were collected using two questionnaires: Demographic characteristics and Quality Patient Care Scale (QUALPACS) and taking a blood sample for HbA1C. The nurse‐led Care interventions were conducted in three stages: Integrated, Interdisciplinary, and Comprehensive. Descriptive and analytic statistical methods were used to analyze the data. P ??.05 was considered significant. The results demonstrated that according to repeated measures test, (before, 4 and 12?weeks after the intervention), the level of QOC dimensions (Psychosocial, communication and physical aspect) in the nurse‐led group had a significant difference with control group ( P ??.0001). Also, according to the results of Independent t test, there was a significant difference in total QOC scoring and HbA1c between intervention and control groups after the intervention and follow up ( P ??.0001). Considering the burden of diabetes and DFUs, it seems that the establishment of a nurse‐led care approach can be an effective strategy to manage and treat these patients, and eliminate the disruption of care and achieve optimal care quality.