Turkiye Klinikleri Journal of Nursing Sciences

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Diyabetik Ayak Bakımında Kanıta Dayalı Hemşirelik Uygulamaları Tanı ve Tedavideki Gelişmeler
Evidence-Based Nursing Practices in Diabetic Foot Care Developments in Diagnosis and Treatment
Sibel YOLCUa
aİstanbul Atlas Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, İç Hastalıkları Hemşireliği ABD, İstanbul,Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(2):602-10
doi: 10.5336/nurses.2023-100312
Article Language: TR
Full Text
ÖZET
 Diabetes mellitus (DM), yaygın olarak görülen ve sakat bırakan metabolik kronik bir hastalıktır. Erişkin popülasyonda diyabet insidansı yıllar içinde komplikasyon riski ile beraber artar. Her beş ampütasyondan dördü rutin ayak bakımı ve düzenli ayak muayeneleri ile önlenebilmektedir. Sağlık hizmeti sağlayıcıları, etkili ve kabul görmüş bir yöntemle diyabetik ayak epizotlarını veya nükslerini önleyerek diyabetik hastaların yaşam kalitesini artırır. Sağlık bakım sağlayıcısı tarafından yapılan rutin bir ayak muayenesi, ayak bakımı ve cilt muayenesini içerir, kanıta dayalı uygulamalar ile sonuca yönelik hasta bakımından sorumlu olmak adına kanıtları uygulamaya koymada ve kullanmada kilit bir role sahiptir. Sağlık bakım hizmetlerinde elde edilen tüm imkânların kullanılmasındaki temel amaç, birey, aile ve toplumun fiziksel, sosyal ve psikolojik olarak en üst düzeyde sağlığı sürdürmesidir. Klinik uygulama kılavuzları, bunu kullanan klinik alan uzmanları için önemli bir referans olduğundan, bu tür kılavuzları hazırlayanların da yüksek metodolojik uygulama becerilerine sahip olması gerekir. Böylece, diyabetik ayak uygulamasında verilen tavsiyeler mümkün olan en güncel kanıt düzeyine sahip olur. Bu durum sonunda ise daha yüksek öneri derecesi ve en güçlü kanıt düzeyine sahip olan diyabetik ayaklı hastalarda değerlendirme ve takip süreci kolaylaşacaktır. Buna rağmen incelenen kılavuzlar ayrıntılı ele alındığında, diyabetik ayak yönetimi için en çok tavsiye edilen müdahalelerin debridman (çok yüksek düzeyde kanıt ve yüksek derecede tavsiye edilir), ayak değerlendirmesi (orta düzeyde kanıt ve oldukça tavsiye edilir) ve tedavi edici ayakkabılar (orta düzeyde kanıt ve oldukça tavsiye edilir) olduğu sonucuna varılabilir.

Anahtar Kelimeler: Diabetes mellitus; diyabetik ayak; kanıta dayalı hemşirelik
ABSTRACT
 Diabetes mellitus (DM) is a common and disabling metabolic chronic disease. The incidence of diabetes in the adult population increases over the years, along with the risk of complications. Four out of every five amputations can be prevented with routine foot care and regular foot examinations. Healthcare providers improve the quality of life of diabetic patients by preventing diabetic foot episodes or relapses through an effective and accepted method. A routine foot exam by a healthcare provider includes a foot care and skin examination, and has a key role in implementing and using evidence to account for evidence-based practices and outcome-oriented patient care. The main purpose of using all the opportunities obtained in health care services is to maintain the highest level of physical, social and psychological health of the individual, family and society. Since clinical practice guidelines are an important reference for clinicians who use them, those who prepare such guidelines must also have high methodological application skills. This way, recommendations for diabetic foot care have the most current level of evidence possible. As a result, the evaluation and follow-up process will be easier in patients with diabetic foot, which has a higher recommendation level and the strongest level of evidence. However, when the guidelines reviewed were considered in detail, the most recommended interventions for diabetic foot management were debridement (very high level of evidence and highly recommended), foot assessment (moderate evidence and highly recommended), and therapeutic footwear (moderate evidence and highly recommended). It can be concluded that it is highly recommended).

Keywords: Diabetes mellitus; diabetic foot; evidence-based nursing
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