Is Educational Fundamental to the Prevention of Diabetic Foot Ulcers

Topics: Diabetes mellitus, Health care, Diabetic foot Pages: 5 (1680 words) Published: December 11, 2012
“Is education fundamental to the prevention of diabetic foot ulcers?” This question was developed using the PICO framework (appendix one). Diabetes is a chronic condition that can have debilitating consequences that can seriously affect a patient’s lifestyle and their contribution to social gain according to the Department of Health and Children (D.O.H.C.) (2008). It is increasing at a rapid rate which is highlighted by The Institute of Public Health (2010) who state that the number of diabetics in Ireland will rise from 143,000 to 194,000 by the year 2015. This will result with more patients presenting with diabetic foot ulcers. Clair (2011) states, that one third of all diabetics are at risk of developing a diabetic foot ulcer and that between seventy to ninety percent of lower limb amputations are preceded by complication. This paper also revealed that every thirty seconds somewhere in the world a lower limb is amputated due to diabetes. The question for this assignment is focused in trying to establish if education is a tool that could aid in prevention of this complication. From clinical experience the author has noticed that when diabetics are on a ward it is mostly their blood sugars that are assessed and for which education is provided, with little regard for the patient’s feet. The five articles that were researched for this assignment contained two meta-analysis studies, 2 systematic reviews and a qualitative study. These articles were sourced from the CINAHL data base and the Cochrane data base of systematic reviews. All of these studies were published within the past five years and can be regarded as current up to date best evidence. The methodology used by these studies includes interviews, random standardised trials and literature reviews. The patients that were participants in these trials were primarily type two diabetics. There was no discrimination relating to the gender or age of the patient. However, most patients were over 50 yrs of age. The healthcare professionals that participated were primarily nurses although physicians and care assistants were also interviewed. Lavery et al (2008) conducted a study to determine the causes of diabetic foot ulcers with the objective of identifying interventions that could prevent them from developing. The study involved the continuing assessment of 87 patients with 103 existing ulcers or who had an ulcer that had been healed for a period greater than one month. It is important to note that patients who had bi-lateral ulcers were regarded as two separate patients. All patients underwent a rigorous physical assessment and were interviewed regarding their condition. This interview would be deemed as a qualitative tool. It was used to determine what the patient knew about their condition and how they felt they developed the ulcer. The findings of this study identified four main causes (appendix two) that contribute to the development of a diabetic foot ulcer. This study highlighted that these wounds can be caused by simple means. In fact the study revealed that the most common cause was ill-fitting shoes. The study did recommend that education is a tool that should be implemented by a nurse or whatever health professional is involved in the care of the patient. The findings of this study would correspond with the work of Nazarako (2010). This article agrees with Lavery et al in how a diabetic ulcer may be formed. It also determines that health professional should be educated on the causes and treatments of the condition. It also states that specialised foot teams should be educated and formulated to aid in the prevention and treatment. A criticism of this paper is that it targeted the health professional and only saw the diabetic as a patient who needed to be treated instead of an entity that should be protected. However it did believe that education relating to diabetes should be in the public domain as a means of preventing the development of diabetes, which would...
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