Qualitative content analysis of complementary topical therapies used to manage diabetic foot in Jordan

Abstract

In order to alleviate diabetic foot problems, patients sometimes seek complementary therapies outside the professional context. This paper describes the use of complementary remedies as a topical treatment for diabetic foot ulcers among Jordanians. Qualitative content analysis was used to analyse written responses of 68 patients with diabetes who have used complementary therapies to treat diabetic foot problems. These 68 persons represented a subgroup of the study population surveyed using a questionnaire, to the effect of investigating diabetic foot treatments provided in Jordan. Informants were recruited from eight healthcare facilities established in the southern part of Jordan plus from one hospital established in the Jordanian capital. The study was approved by the Boards of Ethics of the participating healthcare facilities. Content analysis yielded the category "Complementary Therapies Used", which included a range of household items (olive oil, sesame oil, honey, and vinegar), and also some indigenous Jordanian herbs (Wormwood, Myrrh, Caper, and Henna among others). The remedies were used either as a monotherapy or as mixtures, to the common goal of treating diabetic foot problems. Other interventions like Al-cowy were also sought from traditional healers. Educational campaigns are required to increase the awareness of patients and their families on possible hazards of unwise complementary therapy use. The decisions on the use of such therapies should be made in agreement with the attending healthcare professionals.

Use of Topical Complementary and Alternative Medicines (CAM) in Diabetic Septic Foot Disease in Makkah Region, Western of Saudi Arabia, an Exploratory Study

“…Furthermore, in the Turkish study they found that 35% of the participants used conventional and alternative treatments to treat their diabetic foot ulcers [8]. In a Jordanian study, 68 out of 1100reported the use of complementary therapies as a topical treatment for diabetic foot ulcers [10]. Most of the local studies in Saudi Arabia showed more or less similar results to our study with the exception of only one who ended with amputation [10].…”

“…It is one of the leading causes of kidney failure, lower extremity amputations, and blindness (World Health Organization, 2016). Diabetic patients typically experience peripheral neuropathy, peripheral arterial disease, foot ulcers due to their susceptibility to infection and sepsis, and consequently end with amputations [8] [9] [10]. The overall mortality rate because of Diabetic foot ulcer is high, with nearly 50% mortality within 5 years.…”

An Ethnomedical Perspective of Arabic Traditional Cauterization; Al-Kaiy

“…Sabra is a special type of cauterization which is usually used for the treatment of joints. Sabra is performed using a small piece of Alkaddhh (a flower of a wild tree called "Alqureia") which is put over the diseased joint then fire is applied to it and left until extinction [22]. In Saudi Arabia, Sayed et al reported that 5.1% of participated psychiatric patients used cauterization [23].…”

Healing of diabetic foot ulcer with topical and oral administrations of herbal products: A systematic review and meta‐analysis of randomized controlled trials

“…The disability rate and treatment cost of DFU are significantly high; thus, using cost‐effective and proper treatments is essential, particularly in low‐income and developing countries, due to the limited financial resources 19 . Herbal medicines have been traditionally used for treating DFU because of their low costs and better patient compliance, especially in African and Asian regions, where using medicinal plants to treat ulcers is common knowledge and practice 20,72 . Different self‐prescribed herbal remedies are currently used for treating DFU, particularly in low‐resource areas 73,74 .…”

“…19 Herbal medicines have been traditionally used for treating DFU because of their low costs and better patient compliance, especially in African and Asian regions, where using medicinal plants to treat ulcers is common knowledge and practice. 20 , 72 Different self‐prescribed herbal remedies are currently used for treating DFU, particularly in low‐resource areas. 73 , 74 However, the safety and effectiveness of this complementary intervention are still challenging.…”