Maria do Livramento Saraiva Lucoveis1, Luiz Clemente de Souza Pereira Rolim2, Hermelinda Cordeiro Pedrosa3, João Roberto de Sá4, David G Armstrong5, Maria Angela Boccara de Paula6, Mônica Antar Gamba7. 1. Master's Degree Student, School of Nursing, Federal University of São Paulo, São Paulo, Brazil. 2. Head of Diabetic Neuropathy and Foot Session, Diabetes Center of Federal University of São Paulo, São Paulo, Brazil. 3. Coordinator, Coordinatory of Research, FEPECS (Health Sciences Teaching and Research Foundation), Endocrinology Unit of Taguatinga Regional Hospital, Health Secretariat, Brasilia, Brazil. 4. Affiliate professor, Discipline of Endocrinology and Metabology, Federal University of São Paulo, São Paulo, Brazil. 5. Professor of Surgery and Director, Southwestern Academic Limb Salvage Alliance, Keck School of Medicine of University of Southern California, USA. 6. Professor, Department of Nursing and Nutrition, University of Taubaté, São Paulo, Brazil. 7. Associate Professor, Department of Nursing, Federal University of São Paulo, São Paulo, Brazil.
Abstract
OBJECTIVE: Diabetic foot ulcers can have serious consequences, including amputation. This project aimed to develop and validate a diabetes care management model-a pocket guide on the prevention of foot ulceration to assist health professionals and scientific societies. METHODS: An adaptation of the Iowa method of evidence-based practice to promote high-quality care was employed. After problems are identified, the Iowa method supports the development of an action plan for addressing them. An evidence-based protocol based on the five cornerstones of the 2015 guidance on the diabetic foot by the International Working Group on the Diabetic Foot was developed in two phases and validated using the Delphi technique. RESULTS: A model was developed to promote these five cornerstones, which are the main recommendations for managing the diabetic foot. These are: foot examination; risk assessment for ulceration; education in diabetes; appropriate footwear; and treatment of pre-ulcerative lesions. To adapt this into a health information document, the management model was synthesised and designed as a pocket guide. The model's individual and global content validity indices surpass 0.78 and 0.90 respectively. CONCLUSION: A management model was created and validated, and produced as a pocket guide to deliver instructions on the care and prevention of diabetic foot problems in people with diabetes.
OBJECTIVE: Diabetic foot ulcers can have serious consequences, including amputation. This project aimed to develop and validate a diabetes care management model-a pocket guide on the prevention of foot ulceration to assist health professionals and scientific societies. METHODS: An adaptation of the Iowa method of evidence-based practice to promote high-quality care was employed. After problems are identified, the Iowa method supports the development of an action plan for addressing them. An evidence-based protocol based on the five cornerstones of the 2015 guidance on the diabetic foot by the International Working Group on the Diabetic Foot was developed in two phases and validated using the Delphi technique. RESULTS: A model was developed to promote these five cornerstones, which are the main recommendations for managing the diabetic foot. These are: foot examination; risk assessment for ulceration; education in diabetes; appropriate footwear; and treatment of pre-ulcerative lesions. To adapt this into a health information document, the management model was synthesised and designed as a pocket guide. The model's individual and global content validity indices surpass 0.78 and 0.90 respectively. CONCLUSION: A management model was created and validated, and produced as a pocket guide to deliver instructions on the care and prevention of diabetic foot problems in people with diabetes.
Authors: Robert G Frykberg; Thomas Zgonis; David G Armstrong; Vickie R Driver; John M Giurini; Steven R Kravitz; Adam S Landsman; Lawrence A Lavery; J Christopher Moore; John M Schuberth; Dane K Wukich; Charles Andersen; John V Vanore Journal: J Foot Ankle Surg Date: 2006 Sep-Oct Impact factor: 1.286
Authors: Shan M Bergin; Vanessa L Nube; Jan B Alford; Bernard P Allard; Joel M Gurr; Emma L Holland; Mark W Horsley; Maarten C Kamp; Peter A Lazzarini; Ashim K Sinha; Jason T Warnock; Paul R Wraight Journal: J Foot Ankle Res Date: 2013-02-26 Impact factor: 2.303
Authors: Andrew J M Boulton; David G Armstrong; Stephen F Albert; Robert G Frykberg; Richard Hellman; M Sue Kirkman; Lawrence A Lavery; Joseph W Lemaster; Joseph L Mills; Michael J Mueller; Peter Sheehan; Dane K Wukich Journal: Diabetes Care Date: 2008-08 Impact factor: 19.112