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Title: Nursing practice guideline for foot care for patients with diabetes in Thailand
Author: Namwong, Tassamon
ISNI:       0000 0004 5352 8191
Awarding Body: De Montfort University
Current Institution: De Montfort University
Date of Award: 2014
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Although medical practice guidelines for diabetic foot care exist globally, there is no clear guideline for nurses to direct clinical foot care practices for diabetic patients in Thailand. The purposes of this qualitative study were to explore the current practice of diabetic foot care and to develop a nursing practice guideline for effective foot care. The research design included two phases, consisting of situation exploration and practice guideline development. For the first phase, semi structured interviews were conducted among fifteen diabetic patients, five nurses, and five nurse educators at Prapokklao hospital, Thailand to discover their knowledge and practice in foot care. A content analysis approach was used in data analysis. The findings revealed that, although foot care education was available, diabetic patients lacked knowledge and had poor foot self-care practice. Nurses and educators also had inadequate knowledge about effective diabetic foot care and they had scarcely ever provided advanced practice for foot care. Moreover, patients had not been categorised regarding their foot risk level, nor had they received appropriate levels of foot care to manage their particular situations. For the second phase, a nursing practice guideline was developed. The classical Delphi technique was applied to examine experts’ agreement on the practice guideline contents. A questionnaire was developed, based on the first phase’s information and critical literature review using Soukup’s model. Twenty diabetic foot care experts from around Thailand completed the questionnaire. The acceptance of experts’ agreement was 94-100% in all aspects. A final guideline was developed which consisted of the initial risk assessment of foot ulceration and specific guidance on the interventions. This guideline, based upon local specialist expert opinion, provides a clear resource for referral and standardised procedures for evaluating footwear and screening to detect the risk of foot complications. In conclusion, this current nursing practice guideline for diabetic foot care was the first guideline for Thai nurses to care for diabetic patients in a Thai cultural context, and is based on local specialist experts’ opinion. This foundation work provides the basis for further research and evaluation concerning the prevention of foot complications and foot management for diabetic patients, including evaluating the effectiveness of the current risk assessment form and risk classification procedures.
Supervisor: Not available Sponsor: Praboromarajtchanok Institute for Health Workforce Development ; Thai Ministry of Public Health
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Diabetes foot care ; Nursing practice guideline ; Diabetes foot care in Thailand ; Foot care in diabetes