Journal of advanced nursing · 2023
Effectiveness of continuous home wound care on patients with diabetic foot ulcers.
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Luo YiXin, Mai LiFang, Liu XingZhou, Yang Chuan
Аннотация
AIMS: To explore the effectiveness of continuous home wound care on patients with diabetic foot ulcers (DFUs).
DESIGN: A non-randomized parallel controlled non-inferiority trial.
METHODS: Patients with Wagner grade I-III DFUs hospitalized in two distant campuses of the same hospital were included. All patients received infection treatment and wound bed preparation during hospitalization; after discharge, patients in one of the campuses received routine outpatient wound care, and those treated in the other received continuous home wound care. The per-protocol analysis was performed to compare ulcer healing indicators, knowledge, health belief, self-management behaviour and medical expenses of the two groups.
RESULTS: Between October 2021 and December 2022, 116 patients were enrolled in the study; 107 completed. The home care was not inferior in terms of ulcer healing rate and demonstrated significant enhancements in the understanding of warning signs, health belief and self-management behaviour. Additionally, the home care saved 220.38 yuan (24.32 UK pounds) in direct medical expenses for each additional one square centimetre of ulcer healing.
CONCLUSION: The continuous home wound care enhanced self-management behaviour of the patients and saved their medical expenses while not compromising ulcer healing.
IMPACT: This is to date the first study to conduct continuous home wound care practice for patients with DFUs and confirmed its safety and non-inferiority in ulcer healing, and supported its superiority in improving self-management behaviour and saving medical expenses.
REPORTING METHOD: We have adhered to the transparent reporting of evaluations with nonrandomized designs statements and the corresponding checklist was followed.
PATIENT OR PUBLIC CONTRIBUTION: The patients and their primary caregivers were involved in intervention design, we received input from them about the factors that facilitate and hinder patient self-management behaviours to develop intervention strategies.
DESIGN: A non-randomized parallel controlled non-inferiority trial.
METHODS: Patients with Wagner grade I-III DFUs hospitalized in two distant campuses of the same hospital were included. All patients received infection treatment and wound bed preparation during hospitalization; after discharge, patients in one of the campuses received routine outpatient wound care, and those treated in the other received continuous home wound care. The per-protocol analysis was performed to compare ulcer healing indicators, knowledge, health belief, self-management behaviour and medical expenses of the two groups.
RESULTS: Between October 2021 and December 2022, 116 patients were enrolled in the study; 107 completed. The home care was not inferior in terms of ulcer healing rate and demonstrated significant enhancements in the understanding of warning signs, health belief and self-management behaviour. Additionally, the home care saved 220.38 yuan (24.32 UK pounds) in direct medical expenses for each additional one square centimetre of ulcer healing.
CONCLUSION: The continuous home wound care enhanced self-management behaviour of the patients and saved their medical expenses while not compromising ulcer healing.
IMPACT: This is to date the first study to conduct continuous home wound care practice for patients with DFUs and confirmed its safety and non-inferiority in ulcer healing, and supported its superiority in improving self-management behaviour and saving medical expenses.
REPORTING METHOD: We have adhered to the transparent reporting of evaluations with nonrandomized designs statements and the corresponding checklist was followed.
PATIENT OR PUBLIC CONTRIBUTION: The patients and their primary caregivers were involved in intervention design, we received input from them about the factors that facilitate and hinder patient self-management behaviours to develop intervention strategies.