Needs and preferences regarding a mobile application to support diabetic foot self-care.

OBJECTIVE: To identify the needs and preferences of individuals with type 2 diabetes regarding the functionalities and characteristics for a mobile application to support foot self-care. METHOD: Qualitative research with 16 individuals diagnosed with type 2 diabetes recruited during clinical care at a university hospital in Porto, Portugal. Data were collected through semi-structured interviews between March and June 2022 and analyzed using inductive content analysis. RESULTS: Three categories and nine subcategories were identified. Categories included informational needs, essential functionalities for foot health self-care, and user-relevant experience. The preference for objective, limited data input, flexible, and customizable applications was an important factor influencing technology engagement. CONCLUSION: The research highlighted a preference for customizable and flexible applications, aiding nurses in creating solutions that transform care delivery and enhance the quality of life for individuals living with diabetes.

Diabetic foot social representations about the experiences of people with diabetes mellitus / Pie diabético: representaciones sociales sobre la experiencia de personas con diabetes mellitus / Pé diabético: representações sociais sobre as vivências das pessoas com diabetes mellitus

ABSTRACT Objective: to understand the social representations about the experiences of people with diabetic foot. Method: a qualitative study, based on the Theory of Social Representations, carried out with 28 participants, in reference services for the treatment of diabetic foot in São Luís, Maranhão, Brazil, from February to May 2019. Data collection took place through semi-structured interviews, a script to characterize the sociodemographic and clinical profile and a field diary. Content analysis was applied with the support of a qualitative data analysis software for categorization. Results: the results made it possible to identify two categories: experiencing diabetic foot, with the respective subcategories, and social responses to diabetic foot. The first category includes the following subcategories: cognitive aspects, psycho-affective aspects, social aspects and morality. The social representations of diabetic foot were based on a painful daily experience, with reference to functional loss, dependence on others and difficulty performing activities that were previously usual. Conclusion: the study made it possible to assert that diabetic foot is an object of social representation, showing how people build, connect and apply knowledge. The research constitutes a support tool for the care of people with diabetic foot, as it assists in the planning of interventions with impacts on the development of representations that generate positive health behaviors, from the perspective of foot self-monitoring.

RESUMEN Objetivo: comprender las representaciones sociales sobre la experiencia de personas que padecen pie diabético. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales, realizado con 28 participantes, en servicios de referencia en tratamiento del pie diabético, en São Luís, Maranhão, Brasil, de febrero a mayo de 2019. La recolección de datos se realizó a través de entrevistas semiestructuradas, guía para caracterizar el perfil sociodemográfico y clínico y diario de campo. El análisis de contenido se llevó a cabo con el soporte de un software de análisis de datos cualitativos para la categorización. Resultados: los resultados permitieron identificar dos categorías: la experiencia de vivir con pie diabético, con sus respectivas subcategorías, y respuestas sociales al pie diabético. En la primera categoría, se encuentran las subcategorías: Aspectos cognitivos, Aspectos psicoafectivos, Aspectos sociales y moralidad. Las representaciones sociales del pie diabético se basaron en una experiencia cotidiana dolorosa, con referencia a la pérdida funcional, la dependencia de los demás y la dificultad para realizar actividades que antes eran habituales. Conclusión: el estudio permitió afirmar que el pie diabético es un objeto de representación social y demuestra cómo las personas construyen, conectan y aplican conocimientos. La investigación se constituye en herramienta de apoyo para el cuidado de personas con pie diabético, puesto que contribuye en la planificación de intervenciones que impacten en el desarrollo de representaciones que generen conductas positivas de salud, desde la perspectiva del autocuidado de los pies.

RESUMO Objetivo: compreender as representações sociais sobre as vivências das pessoas com a condição de pé diabético. Método: estudo qualitativo, fundamentado na Teoria das Representações Sociais, realizado com 28 participantes, em serviços de referência no tratamento de pé diabético, em São Luís, Maranhão, Brasil, de fevereiro a maio de 2019. A coleta dos dados ocorreu por meio de entrevistas semiestruturadas, roteiro para caracterização do perfil sociodemográfico e clínico e diário de campo. Aplicou-se análise de conteúdo com suporte do software de análise qualitativa de dados para categorização. Resultados: os resultados possibilitaram identificar duas categorias: vivenciando o pé diabético, com as respectivas subcategorias, e respostas sociais ante o pé diabético. Na primeira categoria, têm-se as subcategorias: aspectos cognitivos, aspectos psicoafetivos, aspectos sociais e moralidade. As representações sociais do pé diabético se sustentaram em vivência cotidiana penosa, com referência à perda funcional, dependência de terceiros e dificuldade de realizar atividades antes habituais. Conclusão: o estudo possibilitou afirmar que o pé diabético é um objeto de representação social, demonstrando o modo como as pessoas constroem, conectam e aplicam conhecimentos. A investigação constitui ferramenta de apoio ao cuidado da pessoa com pé diabético, por auxiliar no planejamento de intervenções com impactos na elaboração de representações que gerem comportamentos positivos em saúde, na perspectiva da autovigilância dos pés.

Quality of life assessment in chronic wound patients using the Wound-QoL and FLQA-Wk instruments.

OBJECTIVES: To evaluate changes in the quality of life of patients with chronic wounds. METHODS: Quantitative research with a cross-sectional design performed with 100 patients with chronic wounds from a university hospital and a Basic Health Unit in southern Brazil. The mean values of the domains of the instruments Wound Quality of Life (Wound-QoL) and Freiburg Life Quality Assessment Wound were compared with sociodemographic variables of age, sex and education. RESULTS: The average age of the participants was 60.98 years old; 41% (n = 41) had diabetic ulcers and 83% (n = 83) treated the wounds for more than 24 months. The total quality of life value was below the mean with 37.50/100 with (Wound-QoL) and 44.20/100 with (FLQA-Wk). The variables of gender, and educational level were not correlated with either of the two instruments used to assess the quality of life. The age variable was significantly correlated with the satisfaction item of the FLQA-Wk. CONCLUSIONS: The quality of life of patients with chronic wounds was considered poor. The age variable was correlated with the satisfaction domain, showing that the older the age, the lower the satisfaction. The use of instruments to evaluate the quality of life of patients with chronic wounds may help an effective treatment plan.

Usability of a mobile application on diabetic foot self-care.

OBJECTIVES: to assess the usability of an app prototype for diabetic foot self-care by an end user. METHODS: a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied. RESULTS: the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype. CONCLUSIONS: the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.

Measurement properties and factor analysis of the Diabetic Foot Ulcer Scale-short form (DFS-SF).

The purpose of this paper is to provide measurement properties evaluation and factor analysis of the Brazilian version of the diabetic foot ulcer scale-short form (DFS-SF). This methodological study evaluated the measurement properties of the DFS-SF by ceiling and floor effect reliability, responsiveness, and structural construct validity. The study included 290 people with diabetic foot under regular follow-up in a specialised outpatient clinic in inland São Paulo. Reliability was assessed by internal consistency using Cronbach's alpha and composite reliability. Ceiling and floor effects were assessed by the percentage of participants who scored the 15% worst (floor) and 15% best (ceiling) possible scale results. Validity was tested by correlating the instrument values with the domains of the Brazilian version of the Short Form Health Survey (SF-36). Responsiveness (n = 34) was accessed through the wound area obtained by photography and evaluated by the Image J Features program and the DFS-SF score at two moments, with a 4-week interval between them. The instrument had good evidence of reliability, shown by adequate internal consistency (Cronbach's alpha in domains >0.70) and compound reliability (0.84 > CC > 0.92); and of convergent validity, by significant positive correlations of moderate to strong magnitude with SF-36. Structural construct validity was examined by applying the DFS-SF confirmatory factor analysis, which indicated that the Brazilian version of the instrument is properly fitted to the original dimensional structure. The ceiling and floor effect analysis showed no ceiling or floor effects. Responsiveness was observed in the wound area, but not in the DFS-SF scores in the times. The Brazilian version of the DFS-SF presented evidence of validity and reliability, suggesting that this instrument is a valid tool for assessing the quality of life of people with diabetic foot in the Brazilian population.

Usability of a mobile application on diabetic foot self-care / Usabilidad de una aplicación móvil en el cuidado con el pie diabético / Usabilidade de um aplicativo móvel sobre o autocuidado com o pé diabético

ABSTRACT Objectives: to assess the usability of an app prototype for diabetic foot self-care by an end user. Methods: a descriptive study that uses heuristic assessment of a hybrid app usability. Fifteen users of an outpatient diabetes care service in a capital of Northeastern Brazil participated in the study during April 2018. The usability measurement tool called Smartphone Usability questionnaiRE was applied. Results: the lowest score was 77 and the highest was 112, with an average usability of 96.1 points. Usability was framed in the last two levels, 70 and 8o. Users now strongly agree (level 70) and fully (level 80) with the assessed items, which represents good usability of the apps prototype. Conclusions: the final product developed focuses on user needs and requirements, which can ensure usability based on effectiveness, efficiency and satisfaction triad.

RESUMEN Objetivos: evaluar la usabilidad del usuario final de un prototipo de aplicación para el autocuidado del pie diabético. Métodos: evaluación descriptiva, heurística de la usabilidad de una aplicación híbrida. Quince usuarios de un servicio ambulatorio de atención de diabetes en una capital del noreste de Brasil participaron en abril de 2018. Se aplicó el instrumento brasileño de medición de usabilidad llamado Smartphone Usability questionnaiRE. Resultados: el puntaje más bajo fue 77 y el más alto fue 112, con una usabilidad promedio de 96.1 puntos. La usabilidad se enmarcó en los dos últimos niveles, 70 y 80. Los usuarios ahora están totalmente de acuerdo (nivel 70) y totalmente (nivel 80) con los elementos evaluados, lo que representa una buena usabilidad del prototipo de una aplicación. Conclusiones: el producto final desarrollado se centra en las necesidades y requisitos del usuario, que pueden garantizar la usabilidad en función de la eficacia, eficiencia y satisfacción de la tríada.

RESUMO Objetivos: avaliar a usabilidade pelo usuário final de um protótipo de aplicativo para o autocuidado com o pé diabético. Métodos: estudo descritivo, de avaliação heurística da usabilidade de um aplicativo híbrido. Participaram 15 usuários de um serviço ambulatorial de atenção à pessoa com diabetes de uma capital do Nordeste brasileiro durante o mês de abril de 2018. Foi aplicado o instrumento de mensuração de usabilidade chamado Smartphone Usability questionnaiRE. Resultados: obteve-se como menor escore 77 e maior 112, com média de usabilidade geral de 96,1 pontos. A usabilidade foi enquadrada nos dois últimos níveis, 70 e 80. Os usuários passam a concordar fortemente (nível 70) e totalmente (nível 80) com os itens avaliados, o que representa boa usabilidade do protótipo de aplicativo. Conclus ões: o produto final desenvolvido tem foco nas necessidades e exigências do usuário, o que pode garantir a usabilidade, com base na tríade eficácia, eficiência e satisfação.

Validation of a booklet on self-care with the diabetic foot.

OBJECTIVE: to describe the validation of the booklet on self-care with the feet of people with diabetes. METHOD: methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus. RESULTS: the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%. CONCLUSION: the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.

Validation of a booklet on self-care with the diabetic foot / Validación de cartilla sobre autocuidado con pies de personas con Diabetes Mellitus / Validação de cartilha sobre autocuidado com pés de pessoas com Diabetes Mellitus

ABSTRACT Objective: to describe the validation of the booklet on self-care with the feet of people with diabetes. Method: methodological study, focusing on the validation of a printed booklet. The content and appearance of the booklet was validated by 23 judges divided into three groups: 11 content and appearance, seven technicians and five of the area of design and marketing. The appearance was validated by 30 people with type 2 Diabetes Mellitus. Results: the judges in the nursing area allowed the validation of material with a Content Validity Index (CVI) of 0.99, judges in the area of design and marketing with Suitability Assessment of Materials (SAM) of 99.2% and the target audience with concordance index of 99.4%. Conclusion: the educational booklet proved to be valid and reliable educational material to be used in order to promote compliance with self-care with the feet of people with Diabetes Mellitus.

RESUMEN Objetivo: describir la validación de cartilla sobre el autocuidado con pies de personas con diabetes. Método: estudio metodológico, con foco en la validación de cartilla impresa. El contenido y apariencia de la cartilla fue validado por 23 jueces divididos en tres grupos: 11 de contenido y aspecto, siete técnicos y cinco del área de diseño y marketing. La apariencia fue validada por 30 personas con Diabetes Mellitus tipo 2. Resultados: los jueces en el área de enfermería posibilitaron la validación del material con Índice de Validez del Contenido (IVC) total de 0,99, jueces del área de diseño y marketing con Suitability Assessment of Materials (SAM): 99,2% y el público objetivo con índice de concordancia: 99,4%. Conclusión: la cartilla educativa se mostró material educativo válido y confiable para ser utilizada, a fin de promover la adhesión al autocuidado con los pies de personas con Diabetes Mellitus.

RESUMO Objetivo: descrever a validação de cartilha sobre o autocuidado com pés de pessoas com diabetes. Método: estudo metodológico, com foco na validação de cartilha impressa. O conteúdo e aparência da cartilha foi validado por 23 juízes divididos em três grupos: 11 de conteúdo e aparência, sete técnicos e cinco da área de design e marketing. A aparência foi validada por 30 pessoas com Diabetes Mellitus tipo 2. Resultados: os juízes na área de enfermagem possibilitaram a validação do material com Índice de Validade do Conteúdo (IVC) total de 0,99, juízes da área de design e marketing com Suitability Assessment of Materials (SAM): 99,2% e o público-alvo com índice de concordância: 99,4%. Conclusão: a cartilha educativa mostrou-se material educativo válido e confiável para ser utilizada, a fim de promover a adesão ao autocuidado com os pés de pessoas com Diabetes Mellitus.

Work ability and productivity in patients with diabetic foot.

OBJECTIVE: To assess work ability and productivity in patients with diabetic foot. METHODS: This investigation was a cross-sectional controlled study. A total of 117 individuals were selected from March to June 2014 and allocated to group A (patients without diabetes, n=43), group B (diabetes patients without foot ulcers, n=43), or group C (patients with diabetic foot, n=31). Two validated instruments, the Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire General Health v2.0 (WPAI-GH), were used to assess work ability and productivity. RESULTS: The groups were homogeneous regarding age and sex; however, patients in group C had a lower education level than the other participants (p=0.006). The median WLQ scores for groups A, B, and C were 0.0121, 0.0146, and 0.0852, respectively (p<0.0001). The WPAI-GH scores revealed a mean productivity loss of 20% for groups A and B and 100% for group C (p<0.0001). CONCLUSIONS: Patients with diabetic foot showed decreased work ability and productivity.

Work ability and productivity in patients with diabetic foot

OBJECTIVE: To assess work ability and productivity in patients with diabetic foot. METHODS: This investigation was a cross-sectional controlled study. A total of 117 individuals were selected from March to June 2014 and allocated to group A (patients without diabetes, n=43), group B (diabetes patients without foot ulcers, n=43), or group C (patients with diabetic foot, n=31). Two validated instruments, the Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire General Health v2.0 (WPAI-GH), were used to assess work ability and productivity. RESULTS: The groups were homogeneous regarding age and sex; however, patients in group C had a lower education level than the other participants (p=0.006). The median WLQ scores for groups A, B, and C were 0.0121, 0.0146, and 0.0852, respectively (p<0.0001). The WPAI-GH scores revealed a mean productivity loss of 20% for groups A and B and 100% for group C (p<0.0001). CONCLUSIONS: Patients with diabetic foot showed decreased work ability and productivity.

Perceived Concerns of Patients at Risk for Lower Extremity Amputation.

Despite a good understanding of risk factors for amputation and the development of multidisciplinary amputation prevention teams, thousands of lower limb amputations are performed on a daily basis. These amputations are often transformative events in the lives of patients with functional, psychological, social, and economic implications. OBJECTIVE: The objective of this investigation is to qualitatively and quantitatively explore the perceived concerns of patients with chronic wounds at risk for lower extremity amputation. MATERIALS AND METHODS: A guided, physician-administered survey was completed by consenting participants. The survey consisted of both open-ended questions and a 10-point scale for specific questions on a variety of potential patient concerns. RESULTS: Although some questions resulted in relatively high and low mean scores, 9 of the 13 specific questions produced a range of responses on a 10-point modified Likert scale. This indicates that there are not necessarily universal patient concerns and that every patient is different and should be treated as such. With that being said, however, the highest levels of concern (mean measurements ≥ 7/10) had to do with recurrence, function, walking, and self-sufficiency. The lowest levels of concern (mean measurement ≤ 5/10) had to do with pain, shoe gear considerations, cost, and cosmetic appearance of an amputation. CONCLUSIONS: It is the authors' hope that this investigation provides wound care professionals with information that will benefit their approach to the education and treatment of patients at risk for amputation as well as lead to future investigations into the emotional and psychological state of patients with chronic lower extremity wounds.

Knowledge and Practices of Diabetes Foot Care and Risk of Developing Foot Ulcers in México May Have Implications for Patients of Méxican Heritage Living in the US.

Purpose The purpose of the study was to examine the relationship between knowledge and foot care practices among adults with type 2 diabetes. Methods A descriptive correlational study examined 200 patients with type 2 diabetes in México. Data collected included the Knowledge and Practices Self-Care Questionnaire and a Podiatry Examination Questionnaire. Data analysis included Pearson's correlations and chi-square tests. Results More than half of the participants had poor knowledge and poor foot care practices. A significant negative correlation between knowledge and practices of foot care and risk of developing diabetes foot ulcers was found. There was no relationship between sociodemographic variables and the risk of developing diabetes foot ulcers. Conclusions Patients with type 2 diabetes served in an outpatient clinic had poor knowledge and practices of foot care. They demonstrated decreased knowledge and practice of foot care and therefore showed a greater risk of developing diabetes foot, which may predispose patients to early complications.

Terahertz imaging for early screening of diabetic foot syndrome: A proof of concept.

Most people with diabetes suffer some deterioration of the feet. Diabetic foot syndrome causes ulceration in about 15% of cases and such deterioration leads to amputation in about 2.5% of diabetic patients, diminishing their quality of life and generating extraordinary costs for patients and public health systems. Currently, there is no objective method for the detection of diabetic foot syndrome in its early stages. We propose terahertz imaging as a method for the evaluation of such deterioration. This screening method could aid the prevention and medical treatment of this condition in the future.

Association of Sociodemographic Factors with Spirituality and Hope in Patients with Diabetic Foot Ulcers.

OBJECTIVE: To evaluate levels of spirituality and hope in patients with diabetic foot ulcers (DFUs) according to sociodemographic factors. DESIGN: This was a primary, prospective, descriptive, analytical, and clinical study. Questionnaires assessing sociodemographic and clinical characteristics of the patients, the Spirituality Self-rating Scale (SSRS), and the Herth Hope Index (HHI) were administered to all participants. SETTING: University-affiliated skilled nursing center and outpatient wound care clinic in Pouso Alegre, Brazil. PATIENTS: Fifty adult patients with DFUs participated in the study. Patients with ischemic diabetic foot and mixed ulcers were excluded from the study. MAIN RESULTS: On average, patients with DFUs had low levels of spirituality (mean SSRS score, 12.6) and low hope for cure (mean HHI, 16.5). Patients younger than 60 years reported significantly lower levels of spirituality (mean SSRS scores, 11.0), and those older than 70 years had significantly lower hope for cure (mean HHI, 12.5) than other age groups (P = .040). Level of spirituality was significantly lower among women (P = .015) and those living with an ulcer for more than 2 years, who also reported significantly lower hope for cure (P = .029) compared with patients having an ulcer for less than 2 years. CONCLUSION: On average, patients with DFUs, especially women and older adults, had a low sense of hope and spirituality. Except for gender, age, and ulcer duration, other sociodemographic and ulcer characteristics had no significant effect on the study population's spirituality and hope.

Quality of life of people with chronic ulcers.

INTRODUCTION: Patients with chronic ulcers have physical, social, and psychological changes that directly affect their quality of life. OBJECTIVES: To evaluate the quality of life and analyze the association between personal and health characteristics in patient quality of life for those with chronic ulcers. METHOD: A cross-sectional study, nonprobabilistic. The questionnaire to evaluate personal and health characteristics and the Ferrans and Power Quality of Life Index-Wound Version were used for the data collection. The sample consisted of 200 patients with chronic ulcers of several etiologies (venous ulcers, pressure ulcers, diabetic ulcers, and mixed) recruited at the basic health units in two cities in the South of Minas Gerais, Brazil. RESULTS: Overall, the study found that their quality of life was rated as good. There was a positive correlation between the different ages (P = 0.0165), number of children (P = 0.0083), and practice of religion (P = 0.0394) with quality of life.

Application of the five stages of grief to diabetic limb loss and amputation.

A potentially underappreciated member of the multidisciplinary approach to diabetic limb salvage is that of psychiatry. Diabetic patients are more likely to experience depression, and diabetic patients with depression are more likely to undergo an amputation. Also, both diabetes and depression independently increase the healthcare costs in the United States. The objective of the present investigation was to increase knowledge among diabetic foot practitioners with respect to psychiatric and other mental health patient-care issues, specifically the potential application of the 5 stages of grief to diabetic limb loss and amputation. We enlisted the assistance of a clinical professor from the psychiatry department at our institution to review the 5 stages of grief, provide context specific for application to diabetic limb loss, and offer clinically relevant guidelines for surgeons to better understand and communicate with their patients at each stage. The 5 stages reviewed were denial, anger, bargaining, depression, and acceptance. We hope that the present review will increase the body of knowledge with respect to relevant psychiatric issues and the diabetic foot and provide a starting point for increased awareness with respect to this important, yet underappreciated, aspect of patient care.

Feelings of powerlessness in individuals with either venous or diabetic foot ulcers.

AIM: To assess feelings of powerlessness in patients with either venous or diabetic foot ulcers. METHODS: This was an exploratory, descriptive, cross-sectional study conducted from May 2010 to August 2012. Two hundred adult patients with either venous leg ulcers (N=100) or diabetic foot ulcers (N=100) were consecutively recruited from an outpatient wound care clinic of a university hospital in the city of São Paulo (Brazil). Eligibility criteria included patients with type 1 and 2 diabetes and foot ulcers, and those with venous leg ulcers and ankle-arm index between 0.8 and 1.0. Patients unable to respond to a questionnaire due to physical or cognitive deficit were excluded. Two instruments were used for data collection: a questionnaire assessing sociodemographic and clinical characteristics, and the Powerlessness Assessment Tool (PAT) for adult patients. RESULTS: Most patients were women, aged 60-70 years, and smokers. Fifty-seven patients (57%) with diabetes had had foot ulcers for 3-6 years and 55 (55%) patients had had venous ulcers for 7-10 years. Wound odor and exudate were present in most ulcers. The total PAT score was significantly higher (P=0.002) for patients with foot ulcers (mean, 57.10) than for patients with venous ulcers (mean, 55.12). The highest mean scores for patients with venous and diabetic foot ulcers were 58.09 and 58.10, respectively, on the "self-perception of decision-making capacity" domain. CONCLUSION: Patients with venous and diabetic foot ulcers had very strong feelings of powerlessness, but these feelings were significantly stronger in those with foot ulcerations.

[A comparative study of social representations of diabetes mellitus and diabetic foot]. / Estudo comparativo das representações sociais sobre diabetes mellitus e pé diabético.

The study aimed to investigate social representations of the terms "diabetes" and "diabetic foot" in different populations. Participants were divided into groups: diabetics (GD); non- diabetics (GN); and non-diabetic healthcare professionals (GP). Personal data were collected, and subjects answered two questions that were expected to evoke five words that came to mind when they thought of "diabetes" and then "diabetic foot". The evoked material was analyzed with the software Ensemble de Programmes Permettant l'Analyse dês Èvocations. A total of 161 subjects participated, including GD (n = 72) with a mean age of 56.12 ± 5.49 years; GN (n = 38) with a mean age of 54.29 ± 7.91 years; and GP (n = 51) with 34.95 ± 7.52 years. The term "diabetes" evoked 297 words in GD, 172 in GN, and 235 words in GP. The term "diabetic foot" evoked 180 words in GD, 90 in GN, and 236 in GP. The groups proved to be anxious for more information, thus confirming the need for awareness-raising and educational programs on diabetes, covering comprehensive issues concerning the disease.

Estudo comparativo das representações sociais sobre diabetes mellitus e pé diabético / A comparative study of social representations of diabetes mellitus and diabetic foot / Estudio comparativo de las representaciones sociales sobre diabetes mellitus y pie diabético

O estudo objetivou investigar a representação social dos termos "diabetes" e "pé diabético" em diferentes populações. Os participantes foram divididos em grupos: diabético (GD); não-diabético (GN); e profissional da área da saúde nãodiabético (GP). Foram coletados os dados pessoais e os sujeitos responderam a duas perguntas nas quais deveriam evocar cinco palavras que viessem à mente quando pensassem em "diabetes" e, depois, em "pé diabético". O material evocado foi analisado pelo software Ensemble de Programmes Permettant l'Analyse dês Èvocations. Participaram 161 sujeitos, sendo GD (n = 72) com idade média de 56,12 ± 5,49 anos; GN (n = 38) com 54,29 ± 7,91 anos; e GP (n = 51) com idades de 34,95 ± 7,52 anos. Para a representação social do termo "diabetes" foram evocadas 297 palavras no GD, 172 no GN e 235 palavras no GP. Para o termo "pé diabético" foram evocadas 180 palavras no GD, 90 no GN e 236 no GP. Os grupos mostraram-se sedentos por maiores informações, confirmando a necessidade de programas de conscientização e educação em diabetes, que contemplem questões globalizantes acerca da doença.

The study aimed to investigate social representations of the terms "diabetes" and "diabetic foot" in different populations. Participants were divided into groups: diabetics (GD); non- diabetics (GN); and non-diabetic healthcare professionals (GP). Personal data were collected, and subjects answered two questions that were expected to evoke five words that came to mind when they thought of "diabetes" and then "diabetic foot". The evoked material was analyzed with the software Ensemble de Programmes Permettant l'Analyse dês Èvocations. A total of 161 subjects participated, including GD (n = 72) with a mean age of 56.12 ± 5.49 years; GN (n = 38) with a mean age of 54.29 ± 7.91 years; and GP (n = 51) with 34.95 ± 7.52 years. The term "diabetes" evoked 297 words in GD, 172 in GN, and 235 words in GP. The term "diabetic foot" evoked 180 words in GD, 90 in GN, and 236 in GP. The groups proved to be anxious for more information, thus confirming the need for awareness-raising and educational programs on diabetes, covering comprehensive issues concerning the disease.

Se realizó un estudio para investigar la representación social de los términos "diabetes" y "pie diabético" en diferentes poblaciones. Los participantes fueron divididos en grupos: diabéticos (GD), no diabéticos (GN), y profesional de la salud no diabéticos (GP). Se recogieron datos de carácter personal y los sujetos respondieron a dos preguntas en las que cinco evocan las palabras que vienen a la mente cuando se piensa en "diabetes" y luego en "pie diabético". El material se analizó mediante software Ensemble de Programmes Permettant l'Analyse dês Èvocations. Participaron 161 sujetos con GD (n = 72) con una edad media de 56,12 ± 5,49 años, GN (n = 38) con 54,29 ± 7,91 años y GP (n = 51) de 34 años 95 ± 7,52 años. Para la representación social del término "diabetes" se evocaron en GD 297 palabras, 172 y 235 en el GP GN. "Pie diabético" se mencionó en los GD 180 palabras, 90 y 236 en el GP GN. Los grupos solicitaban más información, lo que confirma la necesidad de programas de sensibilización y educación sobre la diabetes, que tienen preguntas sobre la globalización de la enfermedad.

Feelings of powerlessness and hope for cure in patients with chronic lower-limb ulcers.

OBJECTIVE: To assess feelings of powerlessness and hope for cure in patients with chronic venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). METHOD: A clinical, analytical, descriptive study was conducted from April to September 2012 in a wound-care clinic in Brazil, on consecutive patients presenting withVLUs and DFUs. The Powerlessness AssessmentTool for Adult Patients (PAT) and the Herth Hope Index (HHI) were used.Total PAT scores range 12-60 and the higher the score, the stronger the feelings of powerlessness. The HHI ranges 12-48, with higher scores indicating higher levels of hope RESULTS: In total, 80 consecutive patients were recruited (40 VLU and 40 DFU). Mean PAT score was 53.3 +/- 9.6 (range 21-60) for DFU patients and 34.3 +/- 7.7 (range 21-60; p = 0.001) forVLU patients, suggesting these individuals had strong feelings of powerlessness. The mean HHI was 16.5 +/- 16.5 (range 12-40) for DFU patients and 27.5 +/- 27.5 (range 12-40; p = 0.001) for patients with VLUs, indicating low levels of hope. CONCLUSION: The results suggest that patients with DFUs had stronger feelings of powerlessness regarding their condition and less hope of recovery compared with patients with VLUs.