INTRODUCTION:
Diabetic foot ulcer (DFU) is one of the most common complications of diabetes, have an annual incidence rate of 1% to 4% and a life time risk of 15 % to 25%. Peripheral neuropathy is a major contributing factor in the development of DFU, along with deformity, callus, trauma, and vascular insufficiency. DFUs are often recalcitrant to treatment and associated with serious medical complications, such as (osteomyelitis), lower limb ischemia, amputation and death. Approximately 15% of lower extremity amputations in patient with diabetes are precipitated by a foot ulcer.
Care of diabetic client’s feet is extremely important to prevent foot ulcer and amputation, patient education about foot care should include advice on daily foot inspection, daily foot wash, Nail cutting and appropriate foot wear. Physical examination should be directed toward the underlying pathology of foot ulceration. Neuropathy may be easily evaluated by monofilament test.
OBJECTIVE:
To assess the effectiveness of foot care package on knowledge and skill regarding foot care among diabetic clients.
METHODOLOGY:
Design:
True experimental pre test and post test design.
Setting:
Diabetic Out Patient Department, Sir Ivan Stedeford Hospital
Participants:
60 diabetic clients, who fulfilled the sample selection criteria, were selected as samples using simple random sampling technique (Lottery Method).
Measurements and Tool:
The level of knowledge was assessed using structured questionnaire and the level of skill was assessed using observational checklist. Both descriptive and inferential statistics were used for analysis.
Intervention Protocol:
It consisted of foot care package in prevention of foot ulcer among diabetic clients.
❖ Brief discussion on the definition, causes, development of foot ulcer, and its manifestation, complications and preventive measures.
❖ Demonstration of foot care technique to diabetic clients which includes daily inspection of feet, cleaning, creaming of feet, trimming of toe nails.
❖ Pamphlets on foot care guidelines.
RESULTS:
The findings of the study revealed that the overall pretest mean score of knowledge was 4.43 with S.D of 1.57 and the overall post test mean score of knowledge was 16.03 with S.D of 1.79 the mean improvement knowledge score was 8.96. It showed that after the administration of foot care package there was a high significant improvement in the knowledge level of the diabetic clients with a‘t’ value of 57.670 at p < 0.001, the overall pretest mean score of skill was 2.93 with S.D 0.78 and the overall post test level of skill score was 8.40 with S.D 0.49. it showed after the administration of foot care package there was a high significant improvement in the skill level of the diabetic clients with a ‘t’ value of 30.767 at p<.0.001 level.
DISCUSSION:
There was a significant improvement on knowledge and skill of diabetic clients in the post test after giving the foot care package. Thus the foot care package was effective in improving the knowledge and skill of diabetic clients which in turn will improve the quality of life and prevent foot ulcer.
Implications for Clinical Practice:
The nurses should update their knowledge by attending seminars, continuing education programmes, workshops and conferences. All nurses who care for the diabetic clients should cultivate the habit of educating prevention advices to the client and family members. The nurses should take initiatives to formulate protocols on various aspects of diabetic foot and render standardized nursing care during hospitalization and on follow up visits. Nurse led educational program should become a reality in India which invites the nurses with higher level of educational qualification should start education based diabetic foot clinic in every community
