Bakgrund: Diabetiska fotsår är en vanlig komplikation bland personer med diabetes. Sårläkningsprocessen och sårbehandlingen är en komplicerad och lång process vilka spelar en central roll i patientens liv. Patientens behov av hälso- och sjukvården är stort och kan leda till en ökad belastning på samhällets funktioner och ekonomi. Sjuksköterskan behöver ha kunskaper om patientens upplevelser av att leva med diabetiska fotsår för att kunna bemöta dem på bästa sätt och ge en personcentrerad vård. Syfte: Syftet var att beskriva patienters upplevelser av att leva med diabetiska fotsår.   Metod: Denna litteraturöversikt inkluderar åtta kvalitativa artiklar och två kvantitativa artiklar som besvarar syftet. Databaserna som användes för resultatartiklarna var CINAHL Complete och Medline with Full Text.    Resultat: Resultatet identifierades av tio artiklar och delades in i tre kategorier: fysisk påverkan, påverkan på det sociala livet och psykologiska aspekter. Första kategorin visar på att patienter känner sig begränsade i rörelser, hur inaktivitet kan påverka vardagslivet samt besvärande symtom som kan upplevas. Inom den andra kategorin beskrivs känslor kring hur diabetiska fotsåren har påverkat patienternas sociala liv. Den tredje kategorin omfattar de psykologiska aspekterna av att leva med diabetiska fotsår, känsla av förlorad identitet och tankar inför framtiden.   Slutsats: Resultatet som framkommer visar på att patienter upplever olika former av fysiska och sociala begränsningar. Det gäller för sjuksköterskan att kunna vara lyhörd, öppen samt ha en helhetssyn för patientens upplevelser. Sjuksköterskan bör med andra professioner samarbeta för på bästa sätt ge patienten stöd som den kan behöva. Genom att utbilda patienten och deras närstående kan öka kunskapen om egenvården samt förebygga eventuella diabetesrelaterade komplikationer. / Background: Diabetic foot ulcers are a common complication amongst people with diabetes. Wound healing process and wound treatment are complicated and long process, and these will play a central role in the patient’s life. The patient’s need for health care is great and can lead to a great burden on society’s functions and finances. The nurse needs to have knowledge of experiences in patients living with diabetic foot ulcers in order to be able to treat them in the best way and provide person-centered care.  Aim: The purpose was to describe patients’ experiences of living with diabetic foot ulcers.  Method: This literature review included eight qualitative articles and two quantitative articles to answer the purpose. The databases used for the results articles were CINAHL Complete and Medline with Full Text. Results: The results were identified by ten articles and divided into three categories: physical impact, impact on social life and psychological aspects. The first category shows that patients feel limited in movement, how inactivity can affect everyday life and troublesome symptoms that can be experienced. The second category describes feelings about how diabetic foot ulcers have affected patients' social lives. The third category includes the psychological aspects of living with diabetic foot ulcers, feelings of lost identity and thoughts for the future.  Conclusion: The results that emerge show that patients’ experience various forms of physical and social limitations. It is important for the nurse to be able to be responsive, open and have a holistic view of the patient's experiences. The nurse should work with other professionals to best provide the patient with the support they may need. By educating the patient and their relatives can increase knowledge about self-care and prevent any diabetes-related complications.

Background: Diabetes – one of the leading non-communicable diseases of our time is steadily increasing in prevalence with each year. The disease is linked to several complications that can have major consequences for both the individual and society at large. Diabetic foot ulcers are one of these complications. Aim: The aim of this study was to investigate preventive nursing measures that can be provided to patients at risk of diabetic foot ulcers. Method: This study was conducted as a literature review. The databases CINAHL and Medline were used to identify relevant articles. The database searches resulted in 11 articles that were included in the study and analyzed with the use of a thematic analysis approach. Results: Three overarching categories that nurses can work within to prevent diabetic foot ulcers were derived from the thematic analysis, namely: Care based on needs, Education and Importance of collaborations. Conclusion: Care based on needs, Education and Collaboration are areas in which the nurse can provide preventive care to patients with diabetes at risk of developing diabetic foot ulcers or to patients with already existing foot ulcers. Based on the studies key concepts, implications on the preventive areas relevance for nursing were drawn. Further studies are recommended to investigate how these nursing measures for preventing diabetic foot ulcers can be disseminated within the nursing profession. By spreading these nursing measures within the profession good conditions for minimizing the disease burden of diabetic foot ulcers can be established. / Bakgrund: Diabetes – en av vår tids främsta icke-smittsamma sjukdomar ökar stadigt i prevalens för varje år som går. Sjukdomen är kopplad till en rad komplikationer, bland annat diabetesfotsår, som kan innebära konsekvenser för individen och samhället i stort. Syfte: Syftet med denna litteraturstudie var att belysa sjuksköterskans preventiva omvårdnadsåtgärder kring fotsår hos patienter med diabetes. Metod: Studien genomfördes som en litteraturstudie. Databaserna CINAHL och Medline användes för att identifiera relevanta artiklar. Sökningarna i databaserna resulterade i 11 artiklar som inkluderades och analyserades med en tematisk analysmetod. Resultat: Den tematiska analysen resulterade i tre övergripande kategorier inom vilka sjuksköterskor kan tillhandahålla preventiva omvårdnadsåtgärder till patienter med diabetes som har eller riskerar att utveckla diabetesfotsår. Slutsats: Vård utifrån behov, Utbildning och Vikten av samarbeten är områden inom vilka sjuksköterskan kan tillhandahålla preventiva omvårdnadsåtgärder till patienter med diabetes som riskerar eller har utvecklat diabetesfotsår. Sett ur de centrala begreppens perspektiv kan slutsatsen att de identifierade omvårdnadsåtgärderna är relevanta för omvårdnad dras. Studiens resultat är således relevanta för sjuksköterskeprofessionen och vidare studier rekommenderas undersöka hur omvårdnadsåtgärderna kan spridas inom professionen. Om omvårdnadsåtgärderna kan spridas inom professionen och tillhandahållas patientgruppen finns goda förutsättningar att förebygga samt lindra den sjukdomsbörda som diabetesfotsår kan leda till.

Diabetes is a condition that can lead to foot ulcers that often progress to amputation of a limb. Providing patients with education about foot care is crucial because it can help to prevent or minimize the incidence of foot ulcer development and amputation of a limb. Foot care education as a strategy not only empowers patients with proper foot care knowledge and skill to support and motivate self-care but can also enhance the partnership between the provider and patient. The purpose of this quality improvement project was the implementation of a sustainable evidence-based foot care program for adult patients with diabetes as a routine organizational protocol for quality improvement in diabetic care in a primary care clinic. The question for this project was: How does the implementation of an evidence-based diabetic foot care protocol impact the health outcomes of diabetic patients in a primary care clinic? Orem’s self-care deficit nursing theory and the logic model for evidence-based practice were used to guide this DNP project. The research method for the quality improvement project was a review of the literature. The participants were staff and adults with diabetes at the primary care clinic. The results of the chart review showed that 80% of the charts included documented foot assessments and patient education, which was an improvement when compared to 40% pre-implementation of the foot care program. The program has improved the foot health knowledge and skills of clinicians and people with diabetes and has also helped to reduce the burden of healthcare costs related to the lower incidence of hospitalization for the treatment of wounds and amputation associated with complications of diabetes.

No description available.

Bakgrund: Diabetes Mellitus är en folksjukdom och ett samlingsnamn för flera olika typer av diabetes. En vanlig komplikation vid långvarig diabetes är fotsår, men vid god egenvård kan dessa fotsår till stor del förebyggas. Syfte: Undersöka personer med diabetes erfarenheter av egenvård relaterat till fotsår. Metod: Litteraturöversikten baserades på åtta vetenskapliga artiklar med kvalitativ design. Sökningen genomfördes i databaserna PubMed och Cinahl. Artiklarna kvalitetsgranskades, analyserades och sammanställdes. Resultat: Personer med diagnosen diabetes har i vissa fall bristande egenvård i relation till fotvård och fotsår. Analysen ledde fram till två huvudkategorier och sex subkategorier. Huvudkategorierna var; Hinder till att utföra egenvård samt Vikten av god kommunikation med vårdpersonal för att främja egenvård.  Konklusion: Personer med diabetes har i många fall bristande kunskap om fotsår. Detta leder till att de i många fall har svårt att utföra en god egenvård. Personanpassad och återkommande information från sjukvården har i många fall stärkt egenvården. / Background: Diabetes Mellitus is a public disease and a collective name for several different types of diabetes. A common complication of long-term diabetes is foot ulcers, but with good self-care, these foot ulcers can largely be prevented.  Aim: Investigate people with diabetes experiences of self-care related to foot ulcers. Methods: The literature review was based on eight scientific articles with a qualitative design. The search was performed through the databases PubMed and Cinahl. The articles were quality reviewed, analyzed and compiled. Results: People diagnosed with diabetes in some cases lack self-care in relation to foot care and foot ulcers. The analysis led to two main categories and six subcategories. The main categories were Obstacles to performing self-care and The importance of good communication with healthcare professionals to promote self-care. Conclusion: People with diabetes often lack knowledge about foot ulcers. In many cases this leads to them having difficulty in performing good self-care. Personalized and recurring information from healthcare has in many cases strengthened self-care.

Preventing diabetic foot ulcers among patients diagnosed with diabetes is an important element of care as diabetic foot ulcers present major medical, psychosocial and economic threats. In addition, about 20% of the diabetic foot ulcer cases will ultimately require amputation and cause greater mortality rates. The purpose of this literature review was to evaluate cellphone use to promote diabetic foot care practices among patients with diabetes. Six electronic databases were searched for articles which included text messaging and or phone interventions geared at improving foot care practices. A total of 14 articles dated 2009-2019 met the inclusion criteria and were included in the review. Cellphone use for text messaging and phone calls to advance diabetic foot care practices appears to be promising. Cellphone interventions among clients diagnosed with diabetes were found to have higher adherence with foot examinations, more frequent foot checks, and better overall performance score of diabetic foot ulcer preventive behaviors. This literature review supports cellphone use for text messaging and phone calls to improve diabetic foot care practices. Particularly among populations with health disparities and limited access to healthcare cellphone improves access to care, is uncomplicated and presents a cost-effective approach to improving diabetic foot care practices.

Yes / To explore the perception of healthcare workers (HCWs) on diabetic foot ulcers (DFU) and foot care in Rotuma, Fiji. Using a qualitative study design, two focus group discussions (FGDs) were conducted among HCWs. A semistructured open-ended questionnaire was used to guide the discussion session. Each FGD was audiorecorded and was transcribed. The transcriptions were then manually analysed using thematic analysis. Rotuma hospital, Fiji. HCWs who were working in Rotuma hospital for at least a year and were involved in clinical foot care of type 2 diabetes mellitus patients were included. There were five main themes, namely, depth of knowledge, quality of care in practice, factors of influence on practice, lack of resources and capacity building. Participants had superficial knowledge that showed lack of in-depth scientific knowledge. A lack of staffing in the clinics affected the delivery of service. Additionally, patients defaulting clinics, late presentations with DFU and traditional medicine also affected the quality of healthcare service in clinics. There was also a need for a multidisciplinary team to prevent and manage DFU. HCWs mostly advised on glycaemic control and ignored offering foot care advice in clinics due mainly to the lack of sound knowledge on foot care. There was also a lack of resources, infrastructure, space and professional development opportunities, which negatively impacted how HCWs deliver foot care services to patients. HCWs lack significant in-depth knowledge on DFU and foot care. In addition, these are the availability of traditional medicine that delays presentations to hospital, further reducing the quality of services. HCWs need to keep their knowledge and skills updated through regular in-service training on foot care. Resources, infrastructure and supply chains need to be maintained by those in power to ensure HCWs deliver quality foot care services.

Aims: The intravenous application of the chlorite-based drug solution WF10 is known to improve wound healing in patients with diabetic foot syndrome. In this retrospective study, we addressed the question, which effects are caused by this drug in patients with diabetic foot ulcers on the hemoglobin A1c value. Methods: Patients received five consecutive daily infusions of WF10. Three patients received a second cycle of WF10, and one patient a third cycle. Results: On a group of twelve patients with diabetic foot syndrome, WF10 gradually reduced the HbA1c values from a high-risk range (9.1 ± 1.6% (76 ± 13 mmol/mol)) into a low-risk range in all patients but one. These values remain low over at least 8 to 12 weeks after the administration of WF10. This drug improved also considerably wound healing processes in eleven patients. Conclusions: The chlorite component of WF10 is known to inactivate efficiently free cytotoxic hemoglobin forms that might accumulate in peripheral blood after hemolysis and induces the removal of predamaged red blood cells from circulation. By these mechanisms WF10 diminished toxic effects of hemolysis, improved microcirculation and glucose consumption in affected tissues, and prevented, thus, below knee amputation.

No description available.

Bakgrund: Ben- och fotsår förutses öka i världen då människor lever längre. Sårsmärta är vanligt förekommande hos patienter som har svårläkta ben- och fotsår och kan behandlas på olika sätt. Distriktssköterskor inom hemsjukvården har ett komplext ansvar för dessa patienter.  Syfte: Syftet med studien var att beskriva distriktssköterskors erfarenheter av smärtbehandling till patienter med svårläkta ben- och fotsår inom hemsjukvården. Metod: Tre hemsjukvårdsenheter med total 14 deltagare intervjuades. Intervjuarna har genomförts i en kommun i södra Sverige och analyserats enligt Graneheim och Lundmans innehållsanalys med manifest ansats.  Resultat: Resultatet presenteras i tre kategorier: Kompetens påverkar möjlighet till smärtbedömning i hemmet, Vikten av tillämpning av olika strategier för smärtbehandling i hemmet och Organisatoriska behov i hemsjukvården. Det framkom att distriktssköterskors kompetens påverkade bedömning av sårsmärta i hemmet. Distriktssköterskorna använde olika strategier för smärtbehandling vid ben- och fotsår. De påtalade även vikten av att ha rätt organisatoriska förutsättningar för att kunna bedriva en säker vård i patienternas hem. Slutsats: Vid smärtbedömning behövs bland annat användning av smärtskattningsinstrument. Distriktssköterskor behöver ha kunskap och möjlighet att använda olika behandlingsstrategier för smärtlindring. Det behövs även tydliga rutiner och gemensamma riktlinjer i arbetet med smärta vid svårläkta ben- och fotsår inom hemsjukvården. / Background: Leg and foot ulcers are expected to increase in the world as people live longer. Ulcer pain is common in patients who have difficult-to-heal leg and foot ulcers and can be treated in different ways. District nurses in home care service have a complex responsibility for these patients. Aim: The aim of the study was to describe district nurses' experiences of pain management for patients with difficult-to-heal leg and foot ulcers in home care service. Method: Three home care service units with a total of 14 participants were interviewed. The interviews were conducted in a municipality in southern Sweden and analyzed according to Graneheim and Lundman's content analysis with a manifest approach. Results: The results are presented in three categories: Competence affect the possibility of pain assessment at home, The importance of applying different strategies for pain management at home and Organizational needs in home care service. It was found that the competence of district nurses influenced the assessment of wound pain in patients' homes. The district nurses used different strategies for pain management of leg and foot ulcers. They also emphasized the importance of having the right organizational conditions to be able to provide safe care in patients' homes. Conclusion: When assessing pain, the use of pain assessment instruments is required, among other things. District nurses need to have the knowledge and ability to use different treatment strategies for pain relief. There is also a need of clear routines and common guidelines in the work with pain in difficult-to-heal leg and foot ulcers in home care service.