Valoración del riesgo de neuropatía periférica diabéticadiseño y validación del procedimiento para cribado enfermero NeuDiaCan

  1. Carlos E. Martínez-Alberto
  2. P. Ruymán Brito-Brito
  3. Domingo A. Fernández-Gutiérrez
  4. Patricia Cabrera-García
  5. Alfonso M. García-Hernández
  6. Sara Darias-Curvo
  7. Armando Aguirre-Jaime
Revista:
Enfermería clínica

ISSN: 1130-8621

Año de publicación: 2020

Volumen: 30

Número: 2

Páginas: 89-98

Tipo: Artículo

DOI: 10.1016/J.ENFCLI.2019.07.006 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Enfermería clínica

Resumen

Objective To design and validate a nursing screening procedure for diabetic peripheral neuropathy in primary care. Methods The study was carried out in three phases. 1)Construction of an item bank to form the procedure with an exit score describing the patient's clinical situation. 2)Test and reduction of the initial tentative procedure on a sample of 50 patients using community nurse consultations, eliminating the components with low inter-intra nurse reliability. 3)Validation of the version of the procedure obtained in the previous step on a sample of 106 patients. Calculation of validity and reliability by eliminating components with low criterion validity with respect to the results of the diagnostic electromyography used as a reference standard. Cut-off points were estimated for the use of the procedure as a screening tool, predictive values, performance, internal consistency and inter-nurse reliability. Results The initial tentative procedure consisted of 12 components that were reduced to 10. In the process of validation of this second version the procedure was simplified again, eventually comprising 6 components, with a cut-off point of 2.5 in its output scale, the point at which it reaches adequate values of sensitivity and negative predictors to be used as a screening instrument. For this cut-off point the inter-intra nurse reliability, criterion validity and predictive validity reached acceptable values. Conclusions NeuDiaCan as a nursing screening procedure for diabetic peripheral neuropathy in primary care is valid, reliable and easy to use.

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Información de financiación

A la fundaci?n Canaria de Investigaci?n Sanitaria (FUNCANIS) por financiar parcialmente este proyecto (FUNCIS Enfermer?a 16/2014). A Isabel Arroyo Santana, Sergio Falero Cruz, Sebasti?n Matos Castro y Juan Jos? Su?rez S?nchez por su considerable contribuci?n en la realizaci?n de este trabajo. A los pacientes diab?ticos participantes, que lo hicieron desinteresadamente y con gran disponibilidad y colaboraci?n.

Financiadores

    • FUNCIS Enfermer?a 16/2014

Referencias bibliográficas

  • C.D. Mathers, D. Loncar Projections of global mortality and burden of disease from 2002 to 2030 PLoS Med, 3 (2006), p. e442
  • J.M. Carrasco Gimeno, M.J. Vicente Edo, J.I. Martín Sánchez, S. García Rodríguez, I. Muñoz Guajardo, J.M. Mengual Gil Complicaciones de la diabetes: Neuropatía diabética Ministerio de Ciencia e Innovación, Madrid (2010)
  • F.J. Tébar Massó, F. Escobar Jiménez La diabetes mellitus en la práctica clínica. Médica Panamericana, Madrid (2009)
  • J.J. Zarranz Neurología (4.ª edición), Elsevier, Barcelona (2008)
  • T. Kvitkina, M. Narres, H. Claessen, S. Droste, S. Morbach, O. Kuss, et al. Incidence of lower extremity amputation in the diabetic compared to the non-diabetic population: A systematic review protocol Syst Rev., 4 (2015), p. 74
  • J. Aragón Sánchez, A. García Rojas, J.L. Lázaro Martínez, Y. Quintana Marrero, M. Maynar Moliner, M. Rabellino, et al. Epidemiology of diabetes-related lower extremity amputations in Gran Canaria, Canary Islands, Spain Diabetes Res Clin Pract., 86 (2009), pp. e6-e8
  • American Diabetes Association Standards of medical care in diabetes—2016 abridged for primary care providers Clin Diabetes., 34 (2016), pp. 3-21
  • Y.F. Chin, J. Liang, W.S. Wang, B.R. Hsu, T.T. Huang The role of foot self-care behavior on developing foot ulcers in diabetic patients with peripheral neuropathy: A prospective study Int J Nurs Stud., 51 (2014), pp. 1568-1574
  • C.E. Martínez Alberto, D.A. Fernández Gutiérrez, P.R. Brito Brito, M. Reyes Abreu, A. Gaona Fernández, R.M. Mellado Tirado, et al. Valoración enfermera de la neuropatía periférica diabética en Atención Primaria en Canarias: Fase inicial del estudio NEUDIACAN Rev ENE Enferm., 11 (2017), p. 717
  • M. Alonso-Fernández, J.J. Mediavilla-Bravo, F. López-Simarro, J.M. Comas-Samper, F. Carramiñana-Barrera, J. Mancera-Romero, et al. Evaluación de la realización del cribado del pie diabético en Atención Primaria Endocrinol Nutr., 61 (2014), pp. 311-317
  • C.E. Martínez Alberto, L. Cuellar Pompa, D.A. Fernández Gutiérrez, P.R. Brito Brito, A.M. García Hernández, S. Darias Curvo, et al. Revisión sistemática en busca de un procedimiento para la valoración enfermera de la neuropatía periférica diabética: segunda fase del estudio NEUDIACAN Rev ENE Enferm., 12 (2018), p. 2
  • K. Bakker, J. Apelqvist, N.C. Schaper, International Working Group on Diabetic Foot Practical guidelines on the management and prevention of the diabetic foot 2011 Diabetes Metab Res Rev., 28 (2012), pp. 225-231
  • M. Monteiro-Soares, E.J. Boyko, J. Ribeiro, I. Ribeiro, M. Dinis-Ribeiro Risk stratification systems for diabetic foot ulcers: A systematic review Diabetologia., 54 (2011), pp. 1190-1199
  • D.L. Longo, D.L. Kasper, J.L. Jameson, A.S. Fauci, S.L. Hauser, J. Loscalzo Harrison's Principles of Internal Medicine (18th ed.), McGraw-Hill Education, México DF (2012)
  • J. Cerda, L. Cifuentes Uso de curvas ROC en investigación clínica. Aspectos teórico-prácticos Rev Chil Infect., 29 (2012), pp. 138-141
  • A. Moghtaderi, A. Bakhshipour, H. Rashidi Validation of Michigan neuropathy screening instrument for diabetic peripheral neuropathy Clin Neurol Neurosurg., 108 (2006), pp. 477-481
  • A. Chawla, R. Chawla, G. Bhasin Validation of Neuropathy Symptoms Score (NSS) and Neuropathy Disability Score (NDS) in clinical evaluation of peripheral neuropathy in diabetes mellitus Diabetologia, 58 (2015), pp. 500-533
  • J.W. Meijer, A.J. Smith, E.V. Sonderen, J.W. Groothoff, W.H. Eisma, T.P. Links Symptom scoring systems to diagnose distal polyneuropathy in diabetes: The Diabetic Neuropathy Symptom score Diabet Med, 19 (2002), pp. 962-965
  • F.J. Aragón Sánchez, J.L. Lázaro Martínez Atlas de manejo práctico del pie diabético Ars Médica, Madrid (2004)
  • J.W. Meijer, E. van Sonderen, E.E. Blaauwwiekel, A.J. Smith, J.W. Groothoff, W.H. Eisma, et al. Diabetic neuropathy examination: A hierarchical scoring system to diagnose distal polyneuropathy in diabetes Diab Care., 23 (2000), pp. 750-753
  • S. Baraz, K. Zarea, H.B. Shahbazian, S.M. Latifi Comparison of the accuracy of monofilament testing at various points of feet in peripheral diabetic neuropathy screening J Diabetes Metab Disord., 13 (2014), p. 19
  • S.A. Bus, J.J. van Netten, L.A. Lavery, M. Monteiro Soares, A. Rasmussen, Y.. Jubiz, et al., International Working Group on the Diabetic Foot IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes Diabetes Metab Res Rev., 32 (2016), pp. 16-24
  • J.W. Meijer, A.J. Smith, J.D. Lefrandt, J.H. van der Hoeven, K. Hoogenberg, T.P. Links Back to basics in diagnosing diabetic polyneuropathy with the tuning fork Diabetes Care., 28 (2005), pp. 2201-2205
  • S.M. Murphy, D.N. Herrmann, M.P. McDermott, S.S. Scherer, M.E. Shy, M.M. Reilly, et al. Reliability of the CMT neuropathy score (second version) in Charcot-Marie-Tooth disease J Periph Nerv Syst., 16 (2011), p. 191
  • V. Bril, B.A. Perkins Validation of the Toronto Clinical Neuropathy Scoring System for diabetic polyneuropathy Diabetes Care., 25 (2002), pp. 2048-2052
  • M. Rahman, S.J. Griffin, W. Rathmann, N.J. Wareham How should peripheral neuropathy be assessed in people with diabetes in primary care? A population-based comparison of four measures Diabet Med., 20 (2003), pp. 368-374
  • A. Caselli, V. Spallone, G.A. Marfia, C. Battista, C. Pachatz, A. Veves, et al. Validation of the nerve axon reflex for the assessment of small nerve fibre dysfunction J Neurol Neurosurg Psychiatry., 77 (2006), pp. 927-932
  • V. Spallone, R. Morganti, C. d’Amato, C. Greco, L. Cacciotti, G.A. Marfia Validation of DN4 as a screening tool for neuropathic pain in painful diabetic polyneuropathy Diabet Med., 29 (2012), pp. 578-585
  • National Institute for Health and Care Excellence (NICE). Diabetic foot problems: Prevention and management; 2015
  • N. Papanas, K. Papatheodorou, D. Christakidis, D. Papazoglou, G. Giassakis, H. Piperidou, et al. Evaluation of a new indicator test for sudomotor function (Neuropad) in the diagnosis of peripheral neuropathy in type 2 diabetic patients Exp Clin Endocrinol Diabetes., 113 (2005), pp. 195-198
Fuente de los datos: Dialnet