title: Beneficial effects of foot care nursing for people with diabetes mellitus: an uncontrolled before and after intervention study.
abstract: OBJECTIVE
  The aim of this study was to assess the effectiveness of a preventative foot care nursing programme for diabetic patients.
  
  
  BACKGROUND
  Foot complications are common in diabetic patients and prevention of such complications requires foot care. However, there is little information on the effectiveness of foot care nursing on the incidence and recurrence of diabetic foot.
  
  
  METHODS
  We developed a diabetic foot care programme based on the International Working Group on the Diabetic Foot. We studied 88 patients who attended our foot care programme for 2 years, and collected data from April 2005 to March 2009. Patients were divided into four groups according to the risk classification, and received foot care. We evaluated the incidence of foot ulceration or recurrence and non-ulcerated foot condition. Characteristics of the patients were analysed using the paired t-test and McNemar's test, and changes in severity of tinea pedis and grade of callus were analysed using Wilcoxon's signed rank sum test.
  
  
  RESULTS
  The programme reduced the severity score of tinea pedis (P < 0·001) and improved callus grade (P < 0·001). All these were evaluated by Wilcoxon's signed rank sum test. None of the patients of risk-group-3 (history of foot ulceration) showed recurrence of callus-related foot ulcers. Six high-risk patients developed foot ulceration during the programme because of minor injury, but the ulcers healed without development of gangrene.
  
  
  CONCLUSIONS
  A nurse-based foot care programme is effective in preventing diabetic foot in diabetic patients.
authors.affiliation: Diabetes Care Unit, Division of Nursing, Osaka University Medical Hospital, Japan. f_yuko@hosp.med.osaka-u.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Ken
authors.initials: K
authors.lastname: Kishida
authors.forename: Mika
authors.initials: M
authors.lastname: Terao
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Takahara
authors.forename: Munehide
authors.initials: M
authors.lastname: Matsuhisa
authors.forename: Tohru
authors.initials: T
authors.lastname: Funahashi
authors.forename: Iichiro
authors.initials: I
authors.lastname: Shimomura
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D002145:Callosities / Q000451:nursing / Q000473:pathology; D003920:Diabetes Mellitus / Q000451:nursing*; D017719:Diabetic Foot / Q000451:nursing* / Q000517:prevention & control; D005260:Female; D006215:Hallux Valgus; D006801:Humans; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis; D010353:Patient Education as Topic; D011315:Preventive Medicine; D015397:Program Evaluation; D012017:Referral and Consultation; D012307:Risk Factors; D055502:Secondary Prevention; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014008:Tinea Pedis / Q000451:nursing / Q000473:pathology; D016896:Treatment Outcome