Abstract
Purpose:Materials and Methods: In 2004, through the usage of questionnaires and foot examinations, a study was conducted at the Istanbul Education and Research Hospital General Surgery and Diabetes Polyclinics on 71 patients comprising individuals already suffering from diabetic foot infections and those under the risk of suffering from diabetic foot infection (stage 0), along with their 57 caregivers (amounting to a total of 128 subjects) to investigate their level of schooling, knowledge of patients/caregivers regarding diabetic foot infections and the relationship of the stages of the infection in accordance with Wagner's diabetic foot wound classification.
Results: Of the patients studied, 74.7%had completed primary school, 18.3%were high school graduates and 7%had received education at a university. 58%of these patients had been given instruction regarding diabetic foot infections while 42%had not. As for the caregivers, 33 (comprising 57.9%) had completed primary school, 22 (38.6%) were high school graduates and 2 (3.5%) were university graduates. Statistical analysis performed with Mann Whitney U test revealed no statistically significant association between Wagner stages and the level of schooling of patients and their caregivers (p>0.05). However, statistical analysis performed through the implementation of Chi-square test resulted in a significant inverse relationship between patients educated in diabetic foot infections and the Wagner stages (p<0.01).
Conclusions: The level of schooling of patients and their caregivers has no effect on the infection stage, however, instructing/educating of patients reduces the infection stage.
Keywords:
Diabetes, foot, wound, caregiver, schooling, Wagner, grade, amputation.
References
1Apelqvist J, Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot. Diabetes Metab Res Rev 2000;16:75-83.
2Tentelouris N, Al-Sabbagh S, Walker M G, et al. Mortality in diabetic and nondiabetic patients after amputations performed from 1990 to 1995. Diabetes Care 2004;27:1598-1604.
3Ragnarson Tennvall G, Apelqvist J. Health-economic consequences of diabetic foot lesions. Clin Infect Dis 2004;39:132-139.
4Ortegon M M, Redekop W K, Niessen L W. Cost-effectiveness of prevention and treatment of the diabetic foot. Diabetes Care 2004;27:901-907.
5Levin M E. Management of diabetic foot: preventing amputation. South Med J 2002;95:10-20.
6Nesbitt J A. Approach to managing diabetic foot ulcers. Can Fam Physician 2004;50:561-567.
7Levin M E. Foot lesions in patient with diabetes mellitus. Endocrinol Metab Clin North Am 1996;25:447-462.
8Foster D W. Diabetes Mellitus. In: Braunwald E, Isselbacher K J, Petersdorf R G, Wilson J D, Martin J B, Fauci A S, editors. Harrison's Prenciples of Internal Medicine. 11'th ed. Hamburg: McGraw-Hill Book Company; 1987. p.1778-1797.
9Wood F C Jr. Disorders of Carbohydrate Metabolism. In: Berkow R, Fletcher A J, Bondy P K, Faling L J, Feinstein A R,et al, editors. The Merck Manual of Diagnosis and Therapy. 15'th ed. Rahway, N.J.,U.S.A.: Merck & Co.Inc.; 1987. p.1069-1088.
10Adlin E V. Endocrine and Metabolic Diseases. In: Myers A R, editor. The National Medical Series for Independent Study, Medicine. Middle East 2'nd ed. Giza, Egypt: Mass Publishing Co.; 1994. p.401-463.
11American Diabetes Association. Consensus development conference on diabetic foot wound care. Diabetes Care 1999;22:1354-1360.
12Horta C A, Vilaverde J, Mendes P, Goncalves I, Serra L I, et al. Evaluation of diabetic foot amputation rate. Acta Med Port 2003;16:373-380.
13Wagner W F. The dysvascular foot: A system for diagnosis and treatment. Foot Ankle Int 1981;2:62-122.
14Younes N A, Albsoul A M, Awad H. Diabetic heel ulcers: a major risk factor for lower extremity amputation. Ostomy Wound Manage 2004;50:50-60.
15Berardis De G, Pellegrini F, Franciosi M, et al. Physician attitudes toward foot care education and foot examination and their correlation with patient practice. Diabetes Care 2004;27:286-287.
16Singh N, Armstrong D G, Lipsky B A. Preventing foot ulcers in patients with diabetes. JAMA 2005;293:217-228.
17Pollock R D, Unwin N C, Connolly V. Knowledge and practice of foot care in people with diabetes. Diabetes Res Clin Pract 2004;64:117-122.
18Batista F, Pinzur M S. Disease knowledge in patients attending a diabetic foot clinic. Foot Ankle Int 2005;26:38-41.
19Bolzoni O, Milan P, Perari D, et al. Educational activities for the prevention of diabetic foot: foot complications at the center for diabetes of Rovigo. Assist Inferm Ric 2004;23:21-25.
20Ramachandran A. Specific problems of the diabetic foot in developing countries. Diabetes Metab Res Rev 2004;20:19-22.
21Mc Intyre M J, Mc Dowell J R. Educating a patient with diabetes about foot care. Br J Nurs 1994;3:75-78.
22Boulton AJM, Schaper NC. Symposium: How should we classify diabetic foot wounds? Program and Abstracts of the 61st Scientific Sessions of the American Diabetes Association; June 22-26, 2001; Philadelphia, Pennsylvania.
23The International Working Group on the Diabetic Foot. International consensus on diagnosing and treating the infected diabetic foot. 4'th International Symposium on the diabetic foot. 22-24 May, 2003; Noordwijkenhout-Netherland.
