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The role of patient education in preventing diabetic foot

Uncontrolled diabetes and its complications including those in the feet and legs leave countless people very sick or in an early grave and the health care system spiralling to find money to continue services. Worldwide billions of dollars are spent on treating the diabetic foot, ulcers and amputations. Up to 85 percent of these amputations can be prevented, positively impacting the lives of many and saving the health care system billions of dollars. A neglected strategy to achieve just that is patient education.

Patient education is the process by which health professionals and others impart information to patients, families and their caregivers that will change their health behaviors or improve their care and health status. Diabetic foot ulceration poses a heavy burden on the patient and the healthcare system, but patient education for prevention of foot ulcer receives little attention. For every dollar spent on ulcer prevention, 10 are spent on ulcer treatment and healing, and for every research study on prevention, 10 are conducted on healing. To embrace patient education as a strategy we need to shift priority in diabetic foot care and research from treatment to the prevention of foot ulcers.

Patient education is a type of health education that may be provided by any healthcare professional who is knowledgeable on the subject and has undertaken appropriate training on patient communication. Patient education was once a job for doctors, but today’s nurses and increasingly health educators assume most of the responsibility for educating patients and helping them to become responsible for their own health. For patients to take a proactive role in their own care they need to understand their condition and work to prevent or minimize complications from any chronic illness like diabetes. We recognize that many patients may not understand complex healthcare information and what to do with that information. Patient education seeks to solve that problem giving patients the knowledge and skills they need.

Usually some patient education is included in the healthcare professional’s training. So, any health professional can provide patient education including the doctor, podiatrist, nurse, pharmacist, etc. More and more these days there are specially trained health educators doing this job such as diabetes educators. It can also be done by trained lay (non-health professionals) educators – persons such as community health volunteers or even trained patients or family members. Patient education can focus on general prevention education or health promotion and disease or treatment specific education. It needs to be easily understood and focus on skill-building rather than just information giving. Many educational programs focus primarily on improving self-management behavior – how the patient takes care of themselves. Encouraging the patient to embrace taking responsibility for their care and health is an important element of patient education. The patients need to know when, how and why they need to make a lifestyle change and actually what to do.

Patient education seeks to improve the patients’:

• Understanding of their medical condition, diagnosis, disease or disability;

• Understanding of treatment options;

• Self-advocacy and adherence (following instructions from health team);

• Outcomes (results of treatment) and fewer complications; and

• Use of health services when needed.

Patient education tips

Begin educating patients with every encounter in your practice or admission. Start educating by learning what the patient already knows first and correct any misinformation. Tell patients the information in layman’s terms or words they can easily understand and use visual aids as often as possible. Continue to ask questions to be sure they understand what you are saying. Use return demonstration where patient shows you how to perform the skill and always involve the patient in all treatment. Ask the patient to explain (step-by-step) their disease or medication/treatment to their family to be sure they understand. Provide patients with written and or electronic information about signs and symptoms of their condition that will require immediate attention. Give a contact in case the patient needs to call or contact you with questions or for help. Other strategies to improve patient results include taking advantage of technology, determining the patient’s learning style and using it. Stimulate the patient’s interest, consider their limitations and strengths and include family members in the education.

How patient education can prevent help the diabetic foot

There are many areas where patient education can improve the outcomes of treatment and prevent diabetic foot complications. From the patient is diagnosed with diabetes it is the best time to see the podiatrist. Their feet are examined and they are educated on how to observe and care for their feet and prevent complications. A schedule for regular visits to check the feet is made. If the patient has an ulcer, they are taught how to dress the ulcer, prevent infections and amputations and when to seek care. Even if the patient had an amputation, education is still important and has proven effective in saving their lives and preventing another amputation. The patient is taught how to care for the amputation site, the need to continue seeing the podiatrist to prevent another amputation on the other foot, shoe modification or prosthesis. Counseling and treatment for depression is also available and recommended along with physical therapy.

Patient education plays a vital role in all aspects of life in patients with chronic diseases like diabetes. It improves care, outcomes as well as quality or life of patients.

 • For more information email us at foothealth242@gmail.com, or to see a podiatrist visit Bahamas Foot Centre, Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Hilltop Medical Centre, East Terrace Centreville or telephone 394-5820; or Lucayan Medical Centre, East Sunrise Highway, Freeport, Grand Bahama, every first and third Thursday, telephone 373-7400.

 

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