Beneficial Affects of Nursing and Diabetic Foot Essay Sample
Beneficial Effects Of Foot Care Nursing For People With Diabetes Mellitus: An Uncontrolled Before And After Intervention Study
The article by Fujiwara and colleagues published in the Journal of Advanced Nursing discusses the benefits of nursing programs to help prevent, treat, and reduce recurrences of diabetic foot complications. Based on eligibility criteria, 88 people were selected. The study excluded patients with orthopedic diseases, cranial nerve disorders, impaired cognitive function, mental disorders, patients receiving chemotherapy, and those that did not follow the 2-year program. The patients were divided into groups according to risk factors using International Working Group on the Diabetic Foot (IWGDF) classification. (p. 1954) Once the patients were classified into groups according to risk factors, a nursing foot care program was devised specific to each risk group. Each group received education and care by a professional nurse that was in accordance with their risk assessment. The 4 groups were: Group 0 (patients with no diabetic neuropathy), Group 1 (patients with diabetic neuropathy), Group 2 (patients with diabetic neuropathy and peripheral arterial disease and foot deformity), and Group 3 (patients with history of foot ulceration). (Table 1)
Results of the study reviewed the recurrence of foot ulcers after the 2-year study. The non-ulcerated foot had an increase in patients free of tinea pedis from 14.8% to 37.5%. (Fujiwara, p. 1958) There was also a significant improvement in callus grade; in the high-risk group, callus grade decreased in 7 of 15 patients. (p. 1958) Six patients of the 88 patients in the study developed foot ulcerations. The ulcers were a result of trauma and burns, and all 6 patients had diabetic neuropathy. These patients were given education regarding foot care and were referred to a dermatologist. No secondary infections or gangrene resulted from these ulcerations. (p. 1958) In my opinion, a strength in this article was Table 1, which demonstrated the diabetic foot care program and the type of care that was administered to the patients. Every diabetic patient is on a different level as far as foot ulcers are concerned. This table breaks it up into risk factors and education/care for each individual group. Also, the table showed the importance of educating patients in each risk-based group.
Weaknesses in the article included the statistical grafts in Figures 2, 3, and 4 because the graphs were difficult to follow. In addition, as the authors noted, “All examinations and interventions were undertaken by a single nurse in our hospital.” (p. 1956) Having one nurse assess and care for all 88 patients creates a bias in the study, even though the nurse was certified in diabetic foot care. Furthermore, 88 patients observed was not a large enough population size to study, especially without a control group for comparison purposes. The study was not able to use a control group of diabetic patients for ethical reasons. However, a study on this topic could potentially follow diabetic patients who are in and out of the hospital setting following the outcomes associated with treatment administered by hospital-based nurses who may not be specifically trained to deal with diabetic foot ulcers. These patients could be considered the “control group.” Considering this article was about the beneficial effects of foot care nursing for people with diabetes, and it was published from the Journal of Advanced Nursing, it fell short of targeting nurses as the direct audience.
For example, Table 1 appeared to be the only area in the article that described foot care administered by nurses. The article seemed to be directed toward a more general HCP audience. This article is beneficial to the nursing profession for a number of reasons. Diabetes is on the rise, with currently 285 million conflicted with adult diabetes; this estimate is expected to increase to 366 million by 2030. (p. 1953) With the incidence of diabetes escalating, foot ulcers will continue to increase as well. (p. 1953) Devising a nursing foot care program for our patients will help reduce the risk of gangrene, foot and toe amputations, and the need for patients to be rehospitalized. Education and continuing to reinforce proper foot care will only continue to benefit our patients, which encompasses my nursing philosophy of providing compassionate care and education to patients of all ages. This was an informative article and a topic that lends great importance to the healthcare field. As indicated by the author, there are not many studies about the beneficial effects of foot care and nursing. (p. 1954) This article is a step in the right direction in educating nurses about appropriate diabetic care, but the study did not comprise a large population size to sufficiently support the article’s conclusions.
Fujiwara, Y., Kishida, K., Terao, M., Takahara, M., Matsuhisa, M., Funahashi, T.,…Shimizu, Y. (2011). Beneficial effects of foot care nursing for people with diabetes mellitus: an uncontrolled before and after intervention study. Journal of Advanced Nursing, 1952-1962. http://dx.doi.org/10.1111/j.1365-2648.2011.05640.x