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调查在一家三级护理医院诊所接受足部护理的体验,这些诊所为糖尿病相关足部溃疡患者提供服务。

Investigating the experience of receiving podiatry care in a tertiary care hospital clinic for people with diabetes related foot ulcers.

机构信息

Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, 5001, Australia.

出版信息

J Foot Ankle Res. 2022 Jul 1;15(1):50. doi: 10.1186/s13047-022-00556-1.

Abstract

BACKGROUND

Diabetes related foot ulcers can have physical, social, emotional, and financial impacts on the daily life and wellbeing of many people living with diabetes. Effective treatment of diabetes related foot ulcers requires a multi-faceted, multi-disciplinary approach involving a podiatrist, other healthcare professionals, and the person with diabetes however, limited research has been conducted on the lived experience of podiatric treatment for diabetes related foot ulcers to understand how people are engaged in their ulcer management. Therefore, this study aimed to explore the lived experience of receiving podiatric treatment for diabetes related foot ulcers in a tertiary care outpatient setting.

METHODS

Ten participants were interviewed. All were male, with mean age of 69 (SD 15) years and currently undergoing podiatric treatment for a diabetes related foot ulcer in a tertiary care setting. Participants with diabetes related foot ulcers were purposively recruited from the outpatient podiatry clinic at a tertiary hospital in a metropolitan region of South Australia. Semi-structured interviews were conducted to gain insight into the lived experience of people receiving podiatric treatment for their foot ulcer and understand how this experience impacts their regular lifestyle. Data were analysed using a thematic analysis method.

RESULTS

Four themes were identified that add an understanding of the lived experience of participants: 'Trusting the podiatrists with the right expertise', 'Personalised care', 'Happy with the service, but not always with prescribed care', and 'It's a long journey'. Participants described professional behaviour including high organisation and hygiene practices and demonstrated expertise as key factors influencing their trust of a podiatrist's care. Information tailored to individual needs was helpful for participants. Offloading devices and ulcer dressings were often burdensome. Podiatric treatment for foot ulcers was a lengthy and onerous experience for all participants.

CONCLUSIONS

The findings of this study suggest podiatrists can use practical strategies of maintaining consistency in who provides podiatry care for the person, demonstration of high organisational and hygiene standards, and using innovation to adapt information and equipment to suit an individual's lifestyle to support positive experiences of podiatric ulcer care. There is a need for further research to understand how a person's experience of podiatric ulcer care differs amongst genders, cultural groups, and healthcare settings to facilitate positive care experiences and reduce treatment burden for all people with diabetes requiring podiatric ulcer treatment.

摘要

背景

糖尿病相关的足部溃疡会对许多患有糖尿病的人的日常生活和健康福祉产生身体、社会、情感和经济方面的影响。有效的糖尿病相关足部溃疡治疗需要多方面、多学科的方法,包括足病医生、其他医疗保健专业人员和糖尿病患者,但对接受足病治疗的糖尿病相关足部溃疡的生活体验进行的研究有限,以了解人们如何参与他们的溃疡管理。因此,本研究旨在探讨在三级保健门诊环境中接受足病治疗的糖尿病相关足部溃疡的生活体验。

方法

对 10 名参与者进行了访谈。所有参与者均为男性,平均年龄 69(SD 15)岁,目前正在三级保健环境中接受足病治疗糖尿病相关足部溃疡。在南澳大利亚大都市地区的一家三级医院的门诊足病诊所,通过目的性抽样招募了患有糖尿病相关足部溃疡的参与者。进行半结构化访谈,以深入了解接受足病治疗足部溃疡的人的生活体验,并了解这种体验如何影响他们的日常生活方式。使用主题分析方法对数据进行分析。

结果

确定了四个主题,这些主题增加了对参与者生活体验的理解:“信任具有正确专业知识的足病医生”、“个性化护理”、“对服务满意,但对规定的护理不满意”和“这是一个漫长的旅程”。参与者描述了专业行为,包括高度的组织和卫生习惯以及表现出的专业知识,这是影响他们对足病医生护理信任的关键因素。针对个人需求提供的信息对参与者很有帮助。减压装置和溃疡敷料常常是沉重的负担。所有参与者都认为,足部溃疡的足病治疗是一个漫长而艰巨的过程。

结论

本研究的结果表明,足病医生可以使用一些切实可行的策略来维持为患者提供足病治疗的人员的一致性,展示出高度的组织和卫生标准,并利用创新来调整信息和设备以适应个人的生活方式,以支持积极的足病溃疡护理体验。需要进一步研究以了解患者的足病溃疡护理体验在性别、文化群体和医疗保健环境之间的差异,以促进所有需要接受足病溃疡治疗的糖尿病患者的积极护理体验并减轻治疗负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02a2/9248168/4ec1fbcbd4bc/13047_2022_556_Fig1_HTML.jpg

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