Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: A prospective study

Vedhara, Kavita; Dawe, Karen; Wetherell, Mark; Miles, Jeremy N. V.; Cullum, Nicky; Dayan, Colin; Drake, Nicola; Price, Patricia Elaine; Tarlton, John F; Weinman, John; Day, A.; Campbell, Rona

doi:10.1016/j.diabres.2014.07.018

Cited by 64 publications

(74 citation statements)

References 25 publications

(38 reference statements)

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“…This challenges the relevance of recent findings by Vedhara et al (36) regarding the importance of DFU-specific beliefs in predicting foot self-care in those with active foot ulcers. While the foot self-care behaviors included in their report (checking of feet, inspecting inside of shoes, washing feet, soaking feet and drying between toes) may well be helpful in DFU prevention, they have little benefit in those with active DFU, where adherence to off-loading rather than preventive foot care is central to the healing of foot ulcers.…”

Section: Discussioncontrasting

confidence: 63%

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation

et al. 2016

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OBJECTIVEStudies indicate that off-loading adherence is low in patients with diabetic foot ulcers (DFUs), which may subsequently delay healing. However, there is little empirical evidence for this relationship or the factors that influence adherence.RESEARCH DESIGN AND METHODSThis prospective, multicenter, international study of 79 (46 from the U.K. and 33 the U.S.) persons with type 2 diabetes and plantar DFUs assessed the association between off-loading adherence and DFU healing over a 6-week period. Additionally, potential demographic, disease, and psychological determinants of adherence were examined. DFUs were off-loaded with a removable device (77% a removable cast walker). Off-loading adherence was assessed objectively by activity monitors. Patient-reported measures included Hospital Anxiety and Depression Scale (HADS), Neuropathy and Foot Ulcer Quality of Life (NeuroQoL) instrument, and Revised Illness Perception Questionnaire (IPQ-R).RESULTSOff-loading adherence was monitored for 35 ± 10 days, and devices were used during 59 ± 22% of subjects' activity. In multivariate analyses, smaller baseline DFU size, U.K. study site, and better off-loading adherence predicted smaller DFU size at 6 weeks (P < 0.05). Better off-loading adherence was, in turn, predicted by larger and more severe baseline DFUs, more severe neuropathy, and NeuroQoL foot pain (P < 0.05). In contrast, greater NeuroQoL postural instability predicted worse off-loading adherence (P < 0.001). HADS and IPQ-R measures were not significantly associated with off-loading adherence.CONCLUSIONSOff-loading adherence is associated with the amount of DFU healing that occurs, while postural instability is a powerful predictor of nonadherence. Clinicians should take this neuropathic symptom into consideration when selecting an off-loading device, as off-loading–induced postural instability may further contribute to nonadherence.

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Section: Discussioncontrasting

confidence: 63%

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation

et al. 2016

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“…It is clear that the uptake and effectiveness of PPC require more than simply providing information to women about the importance of managing their reproduction and pregnancy planning 30. While such information may increase the awareness of women about PPC, underlying beliefs, emotional concerns, and social factors also need to be considered to ensure that the women become actively engaged with and benefit from PPC.…”

Section: Resultsmentioning

confidence: 99%

The experiences of prepregnancy care for women with type 2 diabetes mellitus: a meta-synthesis

Forde¹,

Patelarou²,

Forbes³

2016

IJWH

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BackgroundDiabetes is one of the most common medical conditions affecting pregnancy and is associated with a number of adverse fetal, infant, and maternal outcomes. These adverse outcomes can be avoided or minimized with appropriate prepregnancy care (PPC). However, the uptake of PPC is limited in women with type 2 diabetes mellitus (T2DM). The reasons for poor uptake are multifactorial, reflecting both women’s understanding of pregnancy risks, and limitations in care delivery.MethodsA systematic literature review with meta-synthesis was undertaken to identify qualitative studies exploring experiences of PPC for women with T2DM incorporating the views of women with T2DM and health care professionals (HCPs). Identified studies included were synthesized in a meta-ethnography to develop an understanding of the elements contributing to the uptake of PPC among women with T2DM.ResultsThe systematic review identified seven studies yielding data from 28 women with T2DM and 83 HCPs. The following six third-order constructs were identified from the synthesis: understanding PPC, emotive catalysts, beliefs about reproduction among women with T2DM, relationships and social factors, HCP behaviors and perspectives, and health care system factors. These constructs were used to develop a multifactorial model expressing the interactive issues that shape the reproductive health-seeking behaviors of women with T2DM to identify potential areas for intervention.ConclusionThe uptake of PPC among women with T2DM seems to be informed by their personal orientation to their reproductive needs, their interactions with HCPs, and system-level influences. Future interventions to enhance PPC uptake need to address these underlying issues.

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“…Numerous studies had similarly underscored the effectiveness of beliefs on self-care behaviors [36, 37]. In this respect, the results of the study by Munni et al on diabetic mothers showed that 44–58% of them believed that they had to avoid eating some types of fish due to their effects on increasing excessive fetal activity, congenital anomalies, and other diseases.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of educational intervention based on psychological factors on achieving health outcomes in patients with type 2 diabetes

Salahshouri

Zamani‐Alavijeh

Mahaki

et al. 2018

Diabetol Metab Syndr

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BackgroundManaging type 2 diabetes (T2D) is assumed to be heavily dependent on patients’ active participation in their own self-care behaviors including prescribed diets.ObjectivesThe purpose of the present study was to investigate the effectiveness of educational intervention based on psychological factors on nutritional behaviors as well as levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in patients with T2D referring to diabetes clinics and healthcare centers in the city of Izeh, Iran.MethodsA total number of 145 patients were recruited in this clinical trial and then randomly assigned to two groups of intervention (n = 73 individuals) and control (n = 72 individuals). After that, a researcher-made multi-part questionnaire including a demographic characteristics information form, a nutritional perceptions and beliefs questionnaire; a scale measuring fears, concerns, and discomforts associated with diabetic diet, as well as the valid and reliable Perceived Dietary Adherence Questionnaire were used to collect the required data before and 3 months after the completion of the educational intervention. To this end, the patients in the intervention group attended an educational program for eight sessions but the individuals in the control group only received routine services. Data analysis was also conducted using the SPSS Statistics (Version 18) and via descriptive and inferential statistics.ResultsThe findings revealed that the mean scores of the sub-groups of nutritional perceptions and beliefs (but not exaggerated ones) in the patients assigned to the intervention group were significantly higher than those in the control group after 3 months (p = 0.001). As well, the mean scores of the sub-groups of fears, concerns, and discomforts in patients as well as exaggerated beliefs witnessed a significant decrease in the intervention group compared to those in the control group (p = 0.001) 3 months after the educational intervention. Furthermore, the mean scores of adherence to a healthy diet in the intervention group had significantly increased compared to those in the control group. There was correspondingly a significant descending trend in the average levels of fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) in the intervention group compared to those obtained in the control group (p = 0.001).ConclusionThe results of this study shed light on the importance of the effectiveness of psychological factors on achieving health outcomes in patients with type 2 diabetes (T2D). Moreover, a new combination of diet-related psychological factors in patients with diabetes was introduced in the present study.Trial registration IRCT. IRCT20180308039008N1. Registered 15 April 2018, http://www.irct.ir

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Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: A prospective study

Abstract: Patients' beliefs are important determinants of foot-care practices. They may, therefore, also be influential in determining ulcer outcomes. Interventions aimed at modifying illness beliefs may offer a means for promoting self-care and improving ulcer outcomes.

Cited by 64 publications

References 25 publications

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation

Role and Determinants of Adherence to Off-loading in Diabetic Foot Ulcer Healing: A Prospective Investigation

The experiences of prepregnancy care for women with type 2 diabetes mellitus: a meta-synthesis

Effectiveness of educational intervention based on psychological factors on achieving health outcomes in patients with type 2 diabetes

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