Journal of Korean Academy of Nursing

Research Paper

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.

Citations

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Youn-Jung Lee, Hee Jung Jang
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Establishment of a Nomogram Model for Predicting Cardiovascular and Cerebrovascular Events in Diabetic Nephropathy Patients Receiving Maintenance Hemodialysis
Xiaobing Liu, Caili Yan, Xiuxiu Niu, Jiechun Zeng, Fahd Abd Algalil
Applied Bionics and Biomechanics.2022; 2022: 1. CrossRef
Prognostic factors in diabetes: Comparison of Chi-square automatic interaction detector (CHAID) decision tree technology and logistic regression
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Medicine.2022; 101(42): e31343. CrossRef

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Original Articles

The Effects of Foot Reflexology on Nausea, Vomiting and Fatigue of Breast Cancer Patients Undergoing Chemotherapy: Jin Hyang Yang; Journal of Korean Academy of Nursing 2005;35(1):177-185. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.1.177

Abstract PDF

Purpose

The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.

Method

The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 posttests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.

Results

There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times.

Conclusion

Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy.

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Jeongsoon Lee, Misook Han, Younghae Chung, Jinsun Kim, Jungsook Choi
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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
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Journal of the Korea Academia-Industrial cooperation Society.2012; 13(9): 4053. CrossRef

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Effects of Foot-Reflexology Massage on Fatigue, Stress and Postpartum Depression in Postpartum Women: Mi Son Choi, Eun Ja Lee; J Korean Acad Nurs 2015;45(4):587-594. Published online August 31, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.4.587

Abstract PDF

Purpose

To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women.

Methods

A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test.

Results

The level of fatigue in the experimental group was significantly lower than the control group (t= - 2.74, p =.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t= - 2.19, p =.032). The level of depression in the experimental group was significantly lower than the control group (t= - 3.00, p =.004).

Conclusion

The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.

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Effects of Foot Reflexology on Fatigue, Sleep and Pain: A Systematic Review and Meta-analysis: Jeongsoon Lee, Misook Han, Younghae Chung, Jinsun Kim, Jungsook Choi; J Korean Acad Nurs 2011;41(6):821-833. Published online December 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.6.821

Abstract PDF

Purpose

The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.

Methods

A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.

Results

The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.

Conclusion

This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

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RECENT LITERATURE

Focus on Alternative and Complementary Therapies.2012;[Epub] CrossRef
RECENT LITERATURE

Focus on Alternative and Complementary Therapies.2012;[Epub] CrossRef

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Geriatric Foot Problems and Related Factors in Two Provinces of Korea: Shinmi Kim, Jaehong Ahn, Sookhee Choi, Yunjung Lee; J Korean Acad Nurs 2010;40(2):161-171. Published online April 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.2.161

Abstract PDF

Purpose

The purpose of the study was to identify the prevalence, risk factors and clinical meanings of geriatric foot problems and to suggest implications for the future.

Methods

One hundred eighty nine elderly aged 60 and over from institution as well as community were investigated for their foot conditions by means of a questionnaire including general characteristics, self care capacity, risk factors, foot problem checklist, X-ray, podoscopy and foot scan. Descriptive statistics and χ²-test was performed as appropriate utilizing SPSS version 14. Less than .05 of p-value was adopted as statistical significance level.

Results

All subjects had at least one kind of foot problem and the most prevalent ones were nail problems, foot deformities in order. Prevalence of foot pain and edema was relatively low.

Conclusion

Foot problem in elderly is prevalent and geriatric foot is expected to emerge as one of the most important problems in the geriatric field. Therefore strategies to deal with geriatric foot should be developed and practiced for better quality of life in later life.

Citations

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The effect of foot care protocol applied to older people on foot health problems and foot care behaviours: a randomised controlled trial in a nursing home
Aslıhan Çatıker, Handan Zincir, Emine Ümit Seviğ
Scandinavian Journal of Caring Sciences.2021; 35(4): 1278. CrossRef
Diabetics' Preference in the Design Factors and Performance Requirements of Diabetic Socks
Ji-Eun Lee, Young-Ah Kwon
Journal of the Korean Society of Clothing and Textiles.2011; 35(5): 527. CrossRef

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Effect of Self-Foot Reflexology massage on Depression, Stress Responses and Immune Functions of Middle Aged Women: Yun Mi Lee; Journal of Korean Academy of Nursing 2006;36(1):179-188. Published online February 28, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.1.179

Abstract PDF

Purpose

This study was aimed to identify the effects of a self-foot reflexology massage on depression, stress responses and functions of the immune system of middle-aged women.

Method

This study was a one group pretest-posttest experimental design and the data was collected from August 1^st, 2004 to May 31^st, 2005. The subjects consisted of 46 middle-aged women (40 - 64 years) who were recruited from the Community Health Center in Busan city. Subjects were not treated for 4 weeks, subsequently they were trained in self foot reflexology massage for 2 weeks, and then they did their own daily for 6weeks (2 days at the research center, 5 days at home).The outcome variables were measured 4 times, at baseline, pre training, after training, and after the intervention. The collected data was analyzed using repeated measure ANOVA by the SPSS/WIN program.

Result

There was a statistically significant difference in depression, perceived stress, systolic blood pressure, natural-killer cells and Ig G. However, there was not a statistically significant difference in dyastolic blood pressure, pulse or serum cortisol.

Conclusion

These results suggest that a self-foot reflexology massage could be utilized as an effective nursing intervention to reduce depression and stress responses, and to strengthen immune systems in middle-aged women.

Citations

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The Application of Foot Reflexology for Anxiety and Pain Management in Women's Childbirth: A Literature Review
Farideh Iraj
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Ayşe Çuvadar , Berna Aksoy, Umut Yıldız, Cihan Öztürk
Africa Journal of Nursing and Midwifery.2023;[Epub] CrossRef
The Effect of Foot Reflexology on the Quality of Sexual Life in Hemodialysis Patients: A Randomized Controlled Clinical Trial
Somayeh Zeidabadi, Jaffar Abbas, Parvin Mangolian Shahrbabaki, Mahlagha Dehghan
Sexuality and Disability.2022; 40(3): 567. CrossRef
Effect of Foot Reflexology Intervention on Depression, Anxiety, and Sleep Quality in Adults: A Meta‐Analysis and Metaregression of Randomized Controlled Trials
Wei-Li Wang, Hao-Yuan Hung, Ying-Ren Chen, Kuang-Huei Chen, Szu-Nian Yang, Chi-Ming Chu, Yuan-Yu Chan, Gerhard Litscher
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Nasrin Samadi, Jafar Vakili, Irandokht Allahyari, Mehri Seyedjavadi, Shohreh Moshfeghi, Soraia Ali Mohammadi, Fatemeh Bezaatpour
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A study to evaluate the effectiveness of foot reflexology on depressionamong older adults in selected old age homes.
J Sirumalar
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Effect of self-administered foot reflexology for symptom management in healthy persons: A systematic review and meta-analysis
Hyun Jin Song, Heejeong Son, Hyun-Ju Seo, Heeyoung Lee, Sun Mi Choi, Sanghun Lee
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Jisoo Kim
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Jisoo Kim, Jeong-Sil Choi
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Geriatric Foot Problems and Related Factors in Two Provinces of Korea
Shinmi Kim, Jaehong Ahn, Sookhee Choi, Yunjung Lee
Journal of Korean Academy of Nursing.2010; 40(2): 161. CrossRef
Effects of Self-Foot Reflexology on Stress, Fatigue and Blood Circulation in Premenopausal Middle-Aged Women
Soo Hyun Jang, Kye Ha Kim
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Jina Oh, Chae-Min Yoon
Journal of Korean Academy of Nursing.2008; 38(2): 278. CrossRef

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The Effects of Foot Reflexion Massage on Sleep Disturbance, Depression Disorder, and the Physiological Index of the Elderly: Rye Hun Song, Do Hwan Kim; Journal of Korean Academy of Nursing 2006;36(1):15-24. Published online February 28, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.1.15

Abstract PDF

Purpose

This study was to examine the effects of foot reflexion massage on sleep disturbance, depression disorder, and the physiological index of the elderly in nursing homes.

Method

The research design was a non-equivalent control group pretest-posttest quasi-experimental study. The subjects in this study were 50 elderly people who resided in two different nursing homes in the same region. An experimental group and a control group were organized with 25 subjects respectively, and foot reflexion massage was provided for 12 sessions, 30 minutes per session. The selected dependent variables were sleep disturbance, depression disorder, and physiological indices(blood plasma serotonin, serum cortisol), which were all measured before and after foot reflexion massage was offered. Data analysis included χ²-test, t-test, paired t-test, and ANCOVA, using the SPSS program package.

Result

1. The experimental group improved sleep quality more than the control group. 2. The experimental group had less depression disorder than the control group. 3. The experimental group had higher serotonin levels than the control group.

Conclusion

It's necessary to give foot reflexion massage as a successful nursing intervention to elderly who undergo a change in sleep, and suffer from a depression disorder due to a deterioration in sleep.

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Shinmi Kim, Jaehong Ahn, Sookhee Choi, Yunjung Lee
Journal of Korean Academy of Nursing.2010; 40(2): 161. CrossRef

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