Investigating the Effects of Education on Diabetic Foot: An Interventional Study from Turkey

ABSTRACT Introduction: Diabetic foot wounds are one of the most important causes of long duration hospitalizations regarding diabetic patients. Lower extremity amputation risk is 15 to 40 times higher in diabetics compared to normal population. Methods for preventing diabetic foot wounds are providing good blood glucose regulation, appropriate shoe wearing, foot care, toe-nail care, regular foot examinations and patient education. We aimed to investigate the effects of education level of the patients and the caregivers on the diabetic foot wound. Methods: 67 patients having diabetic foot wound applying to General Surgery, Internal Medicine and Diabetes outpatient clinics of Izmir Tepecik Education and Research Hospital in 2009 and 57 caregiver caring for these patients were analyzed prospectively with a face to face questionnaire for a correlation between education levels of patients and caregivers and Wagner staging of patients’ diabetic foot wounds and foot examination findings. Results: It was found that education levels of patients and caregivers did not affect Wagner staging of the wounds (p=0.167), but patients with regular follow-up and previously educated for diabetic foot wounds had a lower stage of wound (p=0.021). Conclusion: Education level of patients and caregivers was not found to be effective on the stage of the wound, but regular clinical follow-up and patient education had an decreasing  effect on the stage of wound. Whatever the patients’ education levels are, educations on diabetic foot care and providing regular follow up of patients at risk for diabetic foot will decrease the rates of extremity amputations. Keywords : Care Givers, Diabetic Foot, Education/Nursing, Wagner Grade OZET Giris: Alt ekstremite amputasyonu yapilan hastalarin yaklasik %40-60’ini diyabetik hastalar olusturmaktadir. Diyabetik ayak yaralari, diyabetik hastalarin hastanede uzun sure yatislarinin en onemli nedenlerindendir. Diyabet hastasi olanlarda, normal populasyona nazaran alt ekstremite amputasyon riski 15-40 kat daha fazladir.Yara olusmadan yapilacak profilaksi ve olusmus olan diyabetik ayak yaralarinin tedavisi, amputasyonlari ve morbiditeyi %50 azaltmakta ve maliyeti dusurmektedir. Diyabetik ayak yaralarini onlemeye yonelik yontemler; kan sekeri regulasyonu saglanmasi, uygun ayakkabilar giyilmesi, ayak bakimi, ayak tirnagi bakimi, duzenli ayak muayenesi ve hasta egitimidir. Diyabetik ayak yarasi uzerinde, diyabetik ayak hastasi ve bakicisinin ogrenim duzeylerinin etkisini arastirmayi amacladik. Yontem: 2009 yilinda Izmir Tepecik Egitim ve Arastirma Hastanesi Genel Cerrahi, Dahiliye ve diyabet polikliniklerine basvuran, diyabetik ayak yarasi olan toplam 67 hastanin ve bu hastalara evde bakim yapan 57 bakicinin ogrenim duzeyi ile, Wagner siniflamasina gore hastalardaki diyabetik ayak yara evresinin iliskisi ve ayak muayenesi prospektif olarak yuz yuze anket metodu ile arastirildi. Bulgular: Hastalarin ve bakicilarinin ogrenim durumlarinin, Wagner siniflamasina gore diyabetik ayak yarasi Wagner evrelerini etkilemedigi (p=0.167) fakat diyabet izlemlerini duzenli yaptiran ve daha once diyabetik ayak yarasi hakkinda bilgilendirilen hastalarin yara evrelerinin daha dusuk oldugu saptandi (p=0.021). Sonuc: Hastanin ve bakicisinin ogrenim seviyesinin, yara evresi uzerine etkisi olmadigi fakat duzenli klinik takip ve hastanin egitiminin yara evresini iyi yonde etkiledigi ortaya cikmistir. Diyabetik ayak icin risk altindaki hasta grubuna, ogrenim duzeyi ne olursa olsun diyabetik ayak hastaligi hakkinda bir egitim programi uygulamak ve duzenli izlemlerinin yapilmasini saglamak ekstremite amputasyonlarinin oranlarini azaltacaktir. Anahtar kelimeler:   Bakici, Diyabetik Ayak, Egitim/Bakicilik, Wagner Evrelemesi