Nivel de autocuidados en pie diabético y concordancia de 3 sistemas de estratificación de riesgo en una zona básica de salud de Gran Canaria

  1. Héctor González de la Torre
  2. María Luana Quintana Lorenzo
  3. Almudena Lorenzo Navarro
  4. Juan José Suárez Sánchez
  5. Miriam Berenguer Pérez
  6. José Verdú Soriano
Journal:
Enfermería clínica

ISSN: 1130-8621

Year of publication: 2020

Volume: 30

Issue: 2

Pages: 72-81

Type: Article

Export: RIS
DOI: 10.1016/j.enfcli.2019.07.027 DIALNET GOOGLE SCHOLAR

Abstract

Objective To assess the level of self-care in the population with diabetes and determine the risk of diabetic foot lesions through the use of 3stratification systems as well as to establish the degree of concordance between these systems. Method Observational, cross-sectional and descriptive study carried out in the Basic Health Area of Santa Brígida (Gran Canaria-Canary Islands-Spain) in people diagnosed with diabetes (DM Type 1/DM Type 2) (n=182). Interview, physical examination, review of clinical history and completion of the Diabetic Foot Self-Care questionnaire of the University of Malaga were carried out. The risk stratification was then calculated using 3systems (System of the National Institute for Health Care Excellence, Classification of the International Working Group on the Diabetic Foot and High-Risk Diabetic Foot-60-Second Tool©-2012). The Kappa index was calculated to study the concordance between systems, the relative risk of negative screening of one method against another was estimated and the exact Fisher test to establish whether there were differences. Results 30.2% of diabetics had a low level of self-care, 45.1% a medium level and 24.7% a high level. The risk levels calculated were: National Institute for Health Care Excellence Classification (Negative Risk 71.4%-Positive Risk 28.6%), International Working Group on the Diabetic Foot Classification (Negative Risk 67.0%-Positive Risk 33.0%) and High-Risk Diabetic Foot-60-Second Tool© (Negative Risk 62.6%-Positive Risk 37.4%). Conclusions All 3systems have good concordance with each other. The High-Risk Diabetic Foot-60-Second Tool© only distinguishes 2levels of risk but detects a higher percentage of people at risk. The Diabetic Foot Self-Care questionnaire of the University of Malaga may be useful in the context of Primary Care to assess the level of self-care of people with diabetes.