Creating Effective Education to aid the Prevention of Diabetic Foot Ulcers in New Zealand

Abstract

Diabetes is a debilitating chronic condition, affecting increasing numbers of people around the world and in New Zealand. The consequence of prolonged hyperglycaemic levels has far reaching effects in every major system in the body. The focus of this study is the effect diabetes has on the feet, from nerve destruction causing the loss of protective sensation, to blood vessel occlusion. Collectively these effects combine to create a high risk foot, prone to deformity and ulceration. Of particular emphasis is the risk of non-healing wounds and the high rates of amputation that follow. Poor outcomes of non-healing wounds and amputation have far reaching effects for not only the individual concerned, but their Whanau, support network and the health care system. These include poor quality of life, disability and increased financial burdens in addition to the high mortality rate that accompanies amputation. With 15% - 25% of people with diabetes acquiring a diabetic foot ulcer in their life time (Singh, Armstrong, & Lipsky, 2005), education for prevention is imperative to ensure individuals with diabetes remain well and minimise their risk of sustaining a wound. The aim of this study was to look at how education on preventative foot care could be best delivered to be relatable and acceptable to the New Zealand population. A Descriptive, qualitative design was the methodological approached used in this research portfolio and involved semi structured patient interviews, and long answer health practitioner questionnaires, along with an international literature review that contributed to the development of an education guideline that is presented at the end of this study. The guideline reflects a holistic approach to education that is inclusive of the individual’s life journey, Whanau and supports. It is also accommodating of varied learning styles with the supplementation of information in varied media formats. Additionally there is encouragement for follow up post education to answer any addition questions. It is hoped that the outcome of this research will be beneficial to not only people with diabetes, to improve education uptake and utilisation, but also provide an opportunity to reenergise and redesign the current education practices carried out by health professionals, with the ultimate goal being ulcer prevention and improved patient outcomes.