Journal of Korean Academy of Nursing

Development of a Diabetic Foot Ulceration Prediction Model and Nomogram: Lee, Eun Joo , Jeong, Ihn Sook , Woo, Seung Hun , Jung, Hyuk Jae , Han, Eun Jin , Kang, Chang Wan , Hyun, Sookyung; J Korean Acad Nurs 2021;51(3):280-293. Published online June 30, 2021; DOI: https://doi.org/10.4040/jkan.20257

Purpose
This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM).
Methods
This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients’ electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow–Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples.
Results
The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ² = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years.
Conclusion
The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

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A Study on the Relationship of Perceived Self-efficacy and Sick-role behavioral Compliance in Diabetic children: Yeon Hee Choi; Journal of Nurses Academic Society 1996;26(1):127-137. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.1.127

Abstract PDF: This study was designed to identify the relationship of perceived self-efficacy and sick-role behavioral compliance in diabetic children. The forty-two diabetic children participating in this study were selected from outpatients. The period of data collection was August 8 to December 9, 1994. Collected data were analyzed by means of chi-square test, t-test, Pearson correlation using SPSS/PC+. The result are summarized as follows: 1. The mean score of perceived self-efficacy was 3. 21 that of sick-role behavioral compliance 3.17. 2. Perceived self-efficacy and sick-role behavioral compliance had a positive correlation which was statistically significant (r=0.77, P<0.001). 3. There were statistically significant difference in perceived self-efficacy according to age(p<0. 01) and acknowledgment of prescribed calories in the diabetic diet (p<0.001). 4. There were statistically significant difference in sick-role behavioral compliance according to age(p<0.01) and acknowledgment of prescribed calories in the diabetic diet (p<0.001). These results suggest that perceived self-efficacy is an important variable in the compliance of diabetic children. Nursing intervention needs to be directed at promoting perceived self-efficacy to maintain sick ?role behavioral compliance for diabetic children. Therefore programs of nursing intervention should be revised in order to promote perceived self ?efficacy in diabetic children.

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The Experience of Life in with Diabetics: Jeong Seop Lee, Seung Ok Ro, Duck Shin Shin, Mee Hye Kim, Young Mi Jung; Journal of Korean Academy of Nursing 2000;30(5):1219-1229. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.5.1219

Abstract PDF

The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of: 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.

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The Trend of Qualitative Research in Diabetes
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The Effects of Tailored Diabetes Education on Blood Glucose Control and Self-Care
Kyung Sun Hyun, Kwang Mi Kim, Sook Hee Jang
Journal of Korean Academy of Nursing.2009; 39(5): 720. CrossRef

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A Study of Factors Predicting Self-care Behavior in Diabetics: Young Ock Kim; Journal of Korean Academy of Nursing 1998;28(3):625-637. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.3.625

Abstract PDF

To determine factors affecting self-care behavior if diabetics, the relationships of hardiness, family support, demographic and medical variables to self-care behavior were investigated in 180 samples with non-insulin dependent diabetes mellitus. In stepwise multiple regression analysis, 26.76% of the variance in self-care behavior was accounted for by family support(15.52%), age(7.76%), and clinical history(2.07%). To compared the magnitude of predictor's significance by gender, stepwise multiple regression was conducted separatively by gender group. In the male sample 25.22% of the variance in self-care behavior was accounted for by family support, age, and challenge. In the female sample family support, age, and committment were significant predictors in self-care behavior with 28.82% of the variance. The results highlight the value of family support in self-care behavior in diabetics regardless of gender difference. According to the finding of this study, family support is the most significant predictor of self-care behavior in NIDDM. This implicates that in future diabetic care, a family member should be encouraged to participate in the patient education process. Also as hardiness is not supported by a unidimensional construct, more empirical studies are recommended to differentiate the conceptual traits for the three subconcept of hardiness.

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The Effects of a Foot-Reflexo-Massage Education Program on Foot Care in Diabetic Patients: Young Hee Lee; Journal of Korean Academy of Nursing 2003;33(5):633-642. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.5.633

Abstract PDF

Purpose

This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients.

Method

A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA.

Result

There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow.

Conclusion

Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

Citations

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The Effects of a Self-care Management Program for Patients with Diabetic Foot Ulcers
Jung Yoon Kim, Eui-Young Cheon
Journal of Korean Biological Nursing Science.2016; 18(2): 78. CrossRef
The effects of Aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area
Hyeon-Soon Lee, Dong-Oak Kim
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(9): 4053. CrossRef

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