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J Adv Nurs ; 80(8): 3395-3413, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38156736

RESUMO

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.


Assuntos
Pé Diabético , Serviços de Assistência Domiciliar , Cicatrização , Humanos , Pé Diabético/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Autocuidado , Idoso de 80 Anos ou mais
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