糖尿病患者のフットケア実践状況

The purpose of this study was to clarify the actual foot conditions of the patients with diabetes mellitus and the ways of foot care performed by them, and to explore teaching methods for such patents.The subjects were 22 patients with type 2 diabetes mellitus who had received diabetic education during hospitalization. We identified their ages, diabetic conditions and complications through the medical records, and observed directly their feet and the ways in which they were performing foot care.
Only four patients (18.2%) had no trouble with their feet. Even though over 60% answered that they observed their feet every day, over 80% had troubles with their feet. In order to enable the patients to observe, evaluate and to manage their feet properly, it is important for the medical experts to periodically help and work with the patients in observing and discussing their foot problems so that
the patients can judge their own conditions and take appropriate actions by themselves. There was significant difference between appropriate and inappropriate washing on age. It's important to recognize aging as one of the risk factors in diabetic foot problems and come up with age-appropriate ways of taking care of their feet.
　糖尿病教育入院を終え外来通院をしている2型糖尿病患者22名を対象に,足の状態と洗い方を調査しフットケアの指導方法を検討した。診療録から年齢,病状などを調査し,実際に観察することによって,足の状態と洗い方を評価した。足に全く異常がみられなかったのは2割であった。足の観察頻度は「毎日」と答えた者が6割を超えたが,足に異常がある者が8割を超えていた。患者が足の状態を評価し対応を判断できるよう,継続して定期的に医療者と患者が一緒に足を観察して話し合うことが重要である。また,足の洗い方が適切であった者とそうでない者には,年齢に有意な差があった。加齢も足病変のリスクの1つとして捉え,患者の身体能力に応じたフットケアの方法をともに考え,積極的に関わることが重要である。