| Objective:To asses the quality of life (QOL) and the level of knowledge-attitude-practice (KAP) about prevention of diabetic foot (DF) in type 2 diabetes mellitus (T2DM) patients with high risk of DF, and evaluate the effects of comprehensive intervention on T2DM patients with high risk of DF.Methods:A pretest-posttest experimental design was used in this study. There are 84 T2DM patients with high risk of DF from the ward of endocrinology of the Second Xiangya Hospital of Central South University accomplished the study. The total of 84 patients with T2DM was divided into intervention group (42 cases) and control group (42 cases). The patients in control group received the routine diabetic treatment and general diabetes education. The patients in intervention group received comprehensive interventions, which contents of individual education and diabetic foot care from the diabetes education nurse in inpatient department besides the education contents of control group. The effect of comprehensive intervention was evaluated before education and 3 months after intervention with testing questionnaire of SF-36 and KAP questionnaire and metabolic items (FBG, PBG2h, HbAlc, HDL-CH, LDI-CH, TC, TG). The Statistical analyses were performed using SPSS, version 13.0. Patient characterstics and SF-36, KAP score were analyzed using descriptive statistics,χ2 and t tests. All statistical tests were two sided with a of 0.05.Results:1. The gross score of knowledge was 72.46±17.39, score of attitude to prevent DF was 15.64±3.40, score of practice was 29.86±5.41 in 84 patients before intervention. There were 83.33% of the patients with good attitude on prevention of DF, but 66.67% of the patients got low score of knowledge and 51.19% of the patients had bad conduct routine foot care.2. The SF-36 scores in all dimensions in 84 patients were lower than those in normal before intervention. The largest differences in general health among QOL decrease by 47.6%, followed by physical function and emotional function, which reduced by 42.0% and 39.8%. Difference was small in the dimensions of body pain and mental health, lower than the normal people by 6.8% and 10.1%.3. After 3 months of comprehensive intervention, knowledge, attitudes, behavior of patients in intervention group were significantly improved than the control group (P<0.05). Foot injuries during 3 months significantly reduced (P<0.05).4. After 3 months of comprehensive intervention, dimension scores of role physical, vitality, role emotional, mental health and general health of SF-36 in the intervention group were significantly increased compared with the control group (P<0.05). Dimension scores of role emotional and mental health also significantly improved in the intervention group after intervention (P<0.05). In the same period, the control group had no significant difference in SF-36 scores(P>0.05).5. After 3 months, compared metabolic items with the control group, only HbA1c was controlled much better in the intervention group (P<0.05). The intervention group had better control of FBS, PBG2h, HbA1c, HDL-CH after Intervention (P<0.05). PBG2h, HbA1c were significantly decreased in the control group between per-intervention and post-internention (P<0.05).Conclusions:1. Attidude of prevention DF in T2DM patients with high risk of DF is better, but they lack of knowledge and had bad daily foot care to prevent DF.2. Dimensions scores of SF-36 were lower than normal in T2DM patients with high risk of DF. Among dimensions of QOL, general health, physical function and emotional function got the most serious damage.3. Comprehensive intervention on T2DM patients with high risk of DF can effectively improve their prevention knowledge, attitude and behavior to improve the daily foot care, reduce the incidence of foot injuries, improve the level of glycemic control and improve the quality of life.
|
PDF Full Text Request