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- Apelqvist, Jan, et al.
(författare)
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Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients.
- 2011
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Ingår i: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. - : Elsevier BV. - 1097-6809. ; 53, s. 1582-1588
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Peripheral vascular disease (PVD) is an important limiting factor for healing in neuroischemic or ischemic diabetic foot ulcer. The purpose of this study was to identify factors related to healing in patients with diabetes with foot ulcers and severe PVD. METHODS: Patients with diabetes with a foot ulcer, consecutively presenting at a multidisciplinary foot center with a systolic toe pressure <45 mm Hg or an ankle pressure <80 mm Hg were prospectively included, followed according to a preset program, and with the exception of specified exclusions, subjected to angiography offered vascular intervention when applicable. All patients had continuous follow-up until healing or death irrespective of the type of vascular intervention. RESULTS: One thousand one hundred fifty-one patients were included. Eighty-two percent had a toe pressure <45 mm Hg and 49% had an ankle pressure <80 mm Hg. Eight hundred one patients (70%) underwent an angiography. Out of these, 63% had vascular intervention, either percutaneous transluminal angioplasty (PTA; 39%) or reconstructive surgery (24%). Nine percent of the patients had one or more complications after angiography. PTA was multisegmental in 46% and to the crural arteries in 46%. Reconstructive surgery was distal in 51%. Age (P < .001), renal function impairment (P = .005), congestive heart failure (P = .01), number and type of ulcer (P < .001), and severity of PVD (P = .003) affected the outcome of ulcers. PTA and reconstructive vascular surgery increased the probability of healing without amputation (odds ratio [OR], 1.77 and 2.05, respectively). CONCLUSION: Probability of ulcer healing is strongly related to comorbidity, extent of tissue involvement, and severity of PVD in patients with diabetes with severe PVD.
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| 2. |
- Elgzyri, Targ, et al.
(författare)
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Early Revascularization after Admittance to a Diabetic Foot Center Affects the Healing Probability of Ischemic Foot Ulcer in Patients with Diabetes.
- 2014
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 48:4, s. 440-446
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Tidskriftsartikel (refereegranskat)abstract
- There is limited information about whether time from recognition of decreased perfusion to revascularization affects the probability of healing in a patient with a diabetic foot ulcer. The aim of the present study was to examine whether time to revascularization after referral to a multidisciplinary foot center was related to the outcome of foot ulcers in patients with diabetes and severe peripheral arterial disease (PAD).
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| 4. |
- Hjelm, Katarina, et al.
(författare)
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Determinants of ambulatory care in a defined adult Swedish diabetic population.
- 2002
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Ingår i: Diabetes Research and Clinical Practice. - 1872-8227. ; 56:1, s. 49-61
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate factors associated with health care utilisation in ambulatory diabetes care in relation to complications attributable to diabetes mellitus in an adult diabetic population. Methods: A cross-sectional study; standardised interview, physical examination, and an evaluation of medical records, comprising all known diabetic subjects living in six primary health care districts in southern Sweden (N=1861, aged
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| 5. |
- Hjelm, Katarina G, et al.
(författare)
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Beliefs about health and diabetes in men of different ethnic origin
- 2005
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Ingår i: Journal of Advanced Nursing. - Oxon, UK : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 50:1, s. 47-59
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden.BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour.METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden.FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures.CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.
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| 6. |
- Hjelm, Katarina, et al.
(författare)
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Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions.
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 40:6, s. 673-684
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Tidskriftsartikel (refereegranskat)abstract
- Background. No studies have been found regarding beliefs about health and illness in patients with diabetic foot ulcers investigated from a patient perspective. Beliefs might affect self-care and health. Aim. To explore beliefs about health and illness among patients with severe diabetic foot lesions that might affect self-care practice and care-seeking behaviour. Method. The study design was explorative. A purposive sampling procedure was used. Focus group interviews were held, with 10 women and 11 men under 65 years (working age) and six women and 12 men over 65 years (range 23–83 years) with present or previous diabetic foot lesions managed at a specialized multidisciplinary diabetic foot clinic. Findings. Foot problems were perceived by participants as caused by both external and internal factors related to the individual. Self-care was practised to restore health when ill and in daily foot care. When help was needed it was sought in the professional sector. Women were active in self-care and preventive care, searched for information and tried to adapt to the situation. Men more often sought help for acute problems, discussed more foot-related problems, had a pessimistic view of the future, showed a passive attitude, accepted information given and used more complementary care from the lay sector (wife) and/or the professional sector (district nurse, home care staff, podiatrist). Foot lesions caused deterioration of perceived health and quality of life due to decreased ability to be active. Conclusion. The present study emphasizes the need to take into account the existence of different beliefs about health and illness, especially regarding gender, in the prevention and management of the diabetic foot.
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| 7. |
- Hjelm, Katarina, et al.
(författare)
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Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.
- 2007
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Ingår i: Journal of Clinical Nursing: Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.. ; 16:1, s. 168-78
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate patients' perceptions of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care.Method: Semi-structured individual interviews by external evaluators. Participants were females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East.Findings: The present healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation.The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately.
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| 8. |
- Hjelm, Katarina, et al.
(författare)
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Management of gestational diabetes from the patient's perspective - a comparison of Swedish and Middle-Eastern born women.
- 2007
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Ingår i: Journal of Clinical Nursing. - Oxon, UK : Wiley. - 1365-2702 .- 0962-1067. ; 16:1, s. 168-178
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore patients' evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care. Background. No studies comparing patients' perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self-care in foreign- than Swedish-born women and the question is whether the healthcare organization is optimal in meeting different individuals' needs. Design. Explorative study. Method. Semi-structured individual interviews by external evaluators. Participants. Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East. Results. The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation. Conclusions. The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately. Relevance to clinical practice. Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.
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