The clinical question
In diabetic patients (P), are lifestyle changes (I) more effective than foot care(C) in reducing the risk of foot amputations (O)?
Description of research question
The research question looks at which intervention between lifestyle changes and foot care is more effective and provides utmost positive outcomes in diabetes patients at risk of foot amputation. Foot care involves observing food hygiene, wearing of proper shoes, trimming of toenails and seeking treatment arbitrary in the case of a wound on the foot. The lifestyle changes entails quitting smoking, engage in physical exercise, seeking emotional help to eliminate cases of depression or alcoholism and eating nutritious food.
Notably, searching for articles or information about a particular subject on the internet can be challenging due to the huge volume of data that can be found on different websites and authors. However, not all information found on the internet is relevant and scholarly hence, cannot be used to provide secondary information about a particular phenomenon. Therefore, it is important to utilize credited databases that contain useful information on a certain discipline. The medical field has various databases search engines such as MEDLINE, PubMed, OVID, and CINAHL to make the search for materials easy and fast. For this assignment concerning the comparison of two interventions i.e. lifestyle changes and foot care in dropping the incidence of foot amputation I used MEDLINE, PubMed, and CINAHL to search for relevant articles which I can utilize in my evidence-base research. The search terms I used to in search of articles include; foot care and diabetic patients; life changes, foot amputation, diabetes; diabetes, foot care, lifestyle changes, reducing the risk of foot amputation. From the search, I found two articles from CINAHL and PubMed, but these articles were not useful for my clinical problem. These articles include; Coordination of Multiple Services for a Patient with Severe Lymphedema of the Right Lower Extremity (Sylvia et al., 2011) and How to stratify patients at risk for resistant bugs in the skin and soft tissue infections (Guillamet & Kollef, 2016)?
Sylvia, M. B., Spera, E., Hamilton, S. M., Harrington, S., Hartford, J., & Quigley, S. (2011). Coordination of multiple services for a patient with severe lymphedema of the right lower extremity. Critical care nurse, 31(4), 55-68.
This a qualitative research and its research question is; is multiple services effective in treating patients with severe lymphedema on lower extremity (Sylvia et al., 2011). The article is not related to a clinical problem since it does not involve diabetes and foot amputation.
Guillamet, C. V., & Kollef, M. H. (2016). How to stratify patients at risk for resistant bugs in skin and soft tissue infections?. Current opinion in infectious diseases.
This is a qualitative study and research question is; How to stratify patients at risk for resistant bugs in the skin and soft tissue infections? The study does not give details concerning how to take care of foot or lifestyle changes that can be adopted to avoid the risk of foot amputation in diabetic patients.
However, I did found three articles which were relevant to my clinical question. These articles are as follows
Anderson, J. J., Boone, J., Hansen, M., Spenser, L., & Fowler, Z. (2012). A comparison of diabetic smokers and non-smokers who undergo lower extremity amputation: a retrospective review of 112 patients
This quantitative study from PubMed and its question is, does smoking lead amputation in diabetic smokers? This article is relevant since it describe the relationship of an unhealthy lifestyle (smoking) to foot amputation.
Bonner, T., Foster, M., & Spears-Lanoix, E. (2016). Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabetic Foot & Ankle, 7.
This is a quantitative study from PubMed database. The research question is, in patients with diabetes type 2, is foot care knowledge and foot self-care practice interventions effective in preventing foot amputation. This article shows the initiative that patients can take to prevent chances of amputation.
Delea, S., Buckley, C., Hanrahan, A., McGreal, G., Desmond, D., & McHugh, S. (2015). Management of diabetic foot disease and amputation in the Irish health system: a qualitative study of patients’ attitudes and experiences with health services. BMC health services research, 15(1), 251.
This is a quantitative research from PubMed database. The research question is, in patients with diabetes and active foot disease or lower amputations of the limb, what are their experiences and attitudes of foot care services in the country? The study shows the barriers that the patients face in accessing the required medical care services regarding diabetes and foot care.
References
Anderson, J. J., Boone, J., Hansen, M., Spenser, L., & Fowler, Z. (2012). A comparison of diabetic smokers and non-smokers who undergo lower extremity amputation: a retrospective review of 112 patients
Bonner, T., Foster, M., & Spears-Lanoix, E. (2016). Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabetic Foot & Ankle, 7.
Delea, S., Buckley, C., Hanrahan, A., McGreal, G., Desmond, D., & McHugh, S. (2015). Management of diabetic foot disease and amputation in the Irish health system: a qualitative study of patients’ attitudes and experiences with health services. BMC health services research, 15(1), 251.
Guillamet, C. V., & Kollef, M. H. (2016). How to stratify patients at risk for resistant bugs in skin and soft tissue infections?. Current opinion in infectious diseases.
Sylvia, M. B., Spera, E., Hamilton, S. M., Harrington, S., Hartford, J., & Quigley, S. (2011). Coordination of multiple services for a patient with severe lymphedema of the right lower extremity. Critical care nurse, 31(4), 55-68.
