Avaliação clínica do pé diabético e do conhecimento dos pacientes com diabetes em relação aos cuidados com o pé durante o internamento hospitalar
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Tipo
TCC
Data de publicação
2024-05-23
Periódico
Citações (Scopus)
Autores
Chagas, Lucas Matheus Leal
Taborda, Rodrigo Sobroza
Taborda, Rodrigo Sobroza
Orientador
Zella, Maria Augusta Karas
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Resumo
O diabetes mellitus (DM) é a principal causa de amputação não traumática de membros em nosso país. Em torno de 25% dos diabéticos apresentaram complicações nos membros inferiores (1). Sendo o risco de amputação na população diabética 15 vezes maior que na população não diabética. Em torno de 85% das amputações em diabéticos são precedidas por úlceras, o que evidencia a importância da observação dos pés (2). OBJETIVO: Averiguar a prevalência do nível de conhecimento e dos cuidados preventivos com relação ao pé, identificando os pacientes que apresentavam risco de complicações, fazer o exame clínico do pé diabético e propor intervenções através da educação sobre a necessidade de cuidados locais. MÉTODOS: Estudo transversal analítico caso/controle avaliando pacientes com diabetes, acima de 18 anos, internados em um hospital Escola. Utilizamos o questionário de escore neuropático (ECN) na avaliação de sintomas e a avaliação clínica através Ficha simples para rastreamento do pé em risco. Após a coleta de dados, as informações foram comparadas a partir da construção de tabelas de contingência e aplicação do teste Qui-quadrado. RESULTADOS: Foram avaliados 80 pacientes, a maioria com DM2. O autoexame dos pés era realizado por 43,75%, embora apenas 36,25% tinham seus pés examinados em consulta médica. Os sintomas mais prevalentes na avaliação do escore de comprometimento neuropático foram formigamento (37,5%) e queimação (27%). Micose ungueal foi o achado mais prevalente no exame clínico. A piora do escore neuropático foi visto associado à ausência do pulso pedioso. CONCLUSÃO: O autoexame está sendo realizado por 44% dos pacientes com diabetes casos entrevistados.
Diabetes mellitus (DM) is the leading cause of non-traumatic limb amputation in our country. Around 25% of diabetics have complications in the lower limbs (1). The risk of amputation in the diabetic population is 15 times higher than in the non-diabetic population. Around 85% of amputations in diabetics are preceded by ulcers, highlighting the importance of foot observation (2). OBJECTIVE: To investigate the prevalence of knowledge level and preventive care regarding the foot, identifying patients at risk of complications, conducting clinical examination of the diabetic foot, and proposing interventions through education on the need for local care. METHODS: Analytical cross-sectional case-control study evaluating patients with diabetes, aged 18 and above, hospitalized in a teaching hospital. We used the Neuropathic Score Questionnaire (MNSI) to assess symptoms and clinical evaluation through a Simple Form for Foot Risk Screening. After data collection, information was compared using contingency tables and the chi-square test. RESULTS: 80 patients were evaluated, mostly with DM2. Foot self-examination was performed by 43.75%, although only 36.25% had their feet examined during medical consultation. The most prevalent symptoms in the neuropathic impairment score assessment were tingling (37.5%) and burning sensation (27%). Nail fungus was the most prevalent finding in the clinical examination. Worsening of the neuropathic impairment score was associated with the absence of the pedal pulse. CONCLUSION: Self-examination is being performed by 44% of interviewed diabetes patients.
Diabetes mellitus (DM) is the leading cause of non-traumatic limb amputation in our country. Around 25% of diabetics have complications in the lower limbs (1). The risk of amputation in the diabetic population is 15 times higher than in the non-diabetic population. Around 85% of amputations in diabetics are preceded by ulcers, highlighting the importance of foot observation (2). OBJECTIVE: To investigate the prevalence of knowledge level and preventive care regarding the foot, identifying patients at risk of complications, conducting clinical examination of the diabetic foot, and proposing interventions through education on the need for local care. METHODS: Analytical cross-sectional case-control study evaluating patients with diabetes, aged 18 and above, hospitalized in a teaching hospital. We used the Neuropathic Score Questionnaire (MNSI) to assess symptoms and clinical evaluation through a Simple Form for Foot Risk Screening. After data collection, information was compared using contingency tables and the chi-square test. RESULTS: 80 patients were evaluated, mostly with DM2. Foot self-examination was performed by 43.75%, although only 36.25% had their feet examined during medical consultation. The most prevalent symptoms in the neuropathic impairment score assessment were tingling (37.5%) and burning sensation (27%). Nail fungus was the most prevalent finding in the clinical examination. Worsening of the neuropathic impairment score was associated with the absence of the pedal pulse. CONCLUSION: Self-examination is being performed by 44% of interviewed diabetes patients.
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Palavras-chave
pé diabético , ulceração em pé , complicação em diabetes , internamento pé diabético , diabetic foot , foot ulceration , diabetes complication , diabetic foot hospitalization