Publication: Diyabetik yara polikliniğine başvuran hastalarda bakım paketi yaklaşımının ayak bakım davranışlarına ve yara iyileşmesine etkisi
Abstract
Amaç: Bu çalışma diyabetik yarası olan hastalara kanıta dayalı uygulamalardan oluşan bakım paketi yaklaşımı ile ayak bakım davranışlarını standart hale getirmek, var olan yaranın iyileşmesini sağlamak, yeni diyabetik ayak yarasını önlemek, ayak bakım davranışlarına etkisini değerlendirmek amacıyla gerçekleştirildi. Gereç ve Yöntem: Randomize kontrollü deneysel çalışma, 20 Eylül 2023 ve 20 Mart 2024 tarihleri arasında İstanbul’da bir şehir hastanesinin diyabetik yara polikliniğinde yürütüldü. Araştırma, kontrol grubunda 48, müdahale grubunda 49 hasta olmak üzere toplam 97 hasta ile yapıldı. Veriler araştırmacı tarafından hasta ile yüz yüze görüşülerek toplandı. “Hasta Tanılama Formu”, “Nottingham Fonksiyonel Ayak Bakım Tanılama Formu (NAFF)’’, “Diyabetik Ayak Değerlendirme ve Takip Formu’’ kullanıldı. Tanımlayıcı analizlerde ortalama, standart sapma, ortanca, çeyreklik aralığı, minimum-maximum değerler kullanıldı. Kategorik değişkenler Ki Kare testi ile değerlendirildi. İki bağımsız grubun ölçüm değerleriyle karşılaştırılmasında Mann-Whitney U testi, iki bağımlı grubun ölçüm değerleriyle karşılaştırılmasında ise Wilcoxon Sign testi kullanıldı. İstatistiksel anlamlılık p<0,05 olarak kabul edildi. Araştırma protokolü ClinicalTrials’a NCT06464250 protokol numarası ile kaydedilmiştir. Bulgular: Araştırmaya katılan hastaların gruplar arası homojen dağılım gösterdiği, iki grup arasında ilk muayene, 1., 2., 3. kontrollerde toplam “Nottingham Fonksiyonel Ayak Bakım Tanılama Formu (NAFF)’’ puanı ile yara alanı, derinlik değerleri incelendiğine; NAFF toplam puanında müdahale grubunda anlamlı ölçüde fark bulunurken (p<0,001), yara alanı ve derinlik değerleri istatistiksel olarak anlamlı bulunmadı (p>0,05). Sonuç: Araştırma sonucunda kanıta dayalı literatür doğrultusunda uygulanan bakım paketi yaklaşımının diyabetik ayak tanısı konulan hastada ayak bakımına istatistiksel açıdan anlamlı etki ederken, yara iyileşmesi yönünden iyileşme olmakla beraber istatistiksel anlamlı etkisi olmadığı saptandı.
Objective : This study was carried out to standardize foot care behaviors with a care package approach consisting of evidence-based practices for patients with diabetic ulcers, to ensure healing of existing wounds, to prevent new diabetic foot ulcers, and to evaluate the effect on foot care behaviors. Materials and Methods : The randomized controlled experimental study was conducted in the diabetic wound outpatient clinic of a city hospital in Istanbul between September 20, 2023 and March 20, 2024. The study was conducted with a total of 97 patients, 48 in the control group and 49 in the intervention group. Data were collected by the researcher through face-to-face interviews with the patients. “Patient Identification Form”, ‘Nottingham Functional Foot Care Diagnosis Form (NAFF)’, ‘Diabetic Foot Evaluation and Follow-up Form’ were used. Mean, standard deviation, median, quartile range, minimum-maximum values were used in descriptive analyses. Categorical variables were evaluated with chi-square test. Mann-Whitney U test was used to compare the measurement values of two independent groups and Wilcoxon Sign test was used to compare the measurement values of two dependent groups. Statistical significance was accepted as p<0.05. The research protocol was registered in ClinicalTrials with protocol number NCT06464250. Results : When the total ‘Nottingham Functional Foot Care Diagnostic Form (NAFF)’ score and wound area and depth values were examined in the first examination, 1st, 2nd, 3rd controls between the two groups, a significant difference was found in the intervention group in the total NAFF score (p<0.001), while the wound area and depth values were not statistically significant (p>0.05). Conclusion : As a result of the study, it was determined that the care package approach applied in line with the evidence-based literature had a statistically significant effect on foot care in patients diagnosed with diabetic foot, while there was an improvement in terms of wound healing, but there was no statistically significant effect.
Objective : This study was carried out to standardize foot care behaviors with a care package approach consisting of evidence-based practices for patients with diabetic ulcers, to ensure healing of existing wounds, to prevent new diabetic foot ulcers, and to evaluate the effect on foot care behaviors. Materials and Methods : The randomized controlled experimental study was conducted in the diabetic wound outpatient clinic of a city hospital in Istanbul between September 20, 2023 and March 20, 2024. The study was conducted with a total of 97 patients, 48 in the control group and 49 in the intervention group. Data were collected by the researcher through face-to-face interviews with the patients. “Patient Identification Form”, ‘Nottingham Functional Foot Care Diagnosis Form (NAFF)’, ‘Diabetic Foot Evaluation and Follow-up Form’ were used. Mean, standard deviation, median, quartile range, minimum-maximum values were used in descriptive analyses. Categorical variables were evaluated with chi-square test. Mann-Whitney U test was used to compare the measurement values of two independent groups and Wilcoxon Sign test was used to compare the measurement values of two dependent groups. Statistical significance was accepted as p<0.05. The research protocol was registered in ClinicalTrials with protocol number NCT06464250. Results : When the total ‘Nottingham Functional Foot Care Diagnostic Form (NAFF)’ score and wound area and depth values were examined in the first examination, 1st, 2nd, 3rd controls between the two groups, a significant difference was found in the intervention group in the total NAFF score (p<0.001), while the wound area and depth values were not statistically significant (p>0.05). Conclusion : As a result of the study, it was determined that the care package approach applied in line with the evidence-based literature had a statistically significant effect on foot care in patients diagnosed with diabetic foot, while there was an improvement in terms of wound healing, but there was no statistically significant effect.