Cuidado para el bienestar de personas con diabetes tipo 2 con heridas en miembros inferiores según la teoría de Kristen Swanson

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Abstract

RESUMEN El cuidado brindado a las personas con diabetes mellitus tipo 2 (DM2) y heridas en miembros inferiores (MM II) se ha dirigido a la curación de las lesiones. Se requiere reorientar las acciones de los profesionales de enfermería para obtener una intervención más eficaz. Objetivo: Desarrollar un proyecto de gestión del cuidado, orientado por la teoría “Cuidado para el bienestar” de Kristen Swanson. Metodología: Se empleó la herramienta del marco lógico para la atención de los pacientes con DM2 que tienen heridas en MM II. Se presenta el proceso en los tres momentos de cuidado dispuestos por la teoría: conocer; mantener la fe y estar con; y hacer por y permitir. Resultados: Se evidencia el desconocimiento sobre la DM2 que tienen las personas y el trabajo realizado para superar esta limitación, acompañarlos en su desarrollo y favorecer su capacidad de cuidado, incluida la adherencia al tratamiento. Conclusiones: La intervención de “Cuidado para el bienestar” mostró resultados positivos en los indicadores propuestos dentro de los tres momentos y generó conductas que favorecieron la adherencia al cuidado de la salud y el de sus heridas, logrando así mejorar el bienestar de las personas con DM2 y un beneficio para la institución, al innovar en esquemas de cuidado dirigidos.

Translated abstract

ABSTRACT Care that is given to those who have type II diabetes mellitus (DM2) and wounds in lower limbs mainly focuses on the healing of said wounds, but there is a call for nursing professionals to reorient their actions towards more efficient interventions. Aim: Developt a management project of care, focused on the theory of caring by Kristen Swanson. Methodology: This project, which uses the tool of a logic framework for the care of patients with lower limb wounds and DM2. The process is divided into three moments of care, which are given by the theory: to know; maintaining belief; and doing for and enabling the patient. Results: Lack of knowledge towards DM2 and towards the work put into overcoming this limitation, following the development of it, and encouraging the capacity of care, including adherence to treatment. Conclusions: The intervention of Care for wellness showed positive results in proposed indicators during the tree moments, which in turn generated conducts that favored the adherence to the care for their health and their wounds and, by doing so, achieving an improvement in the wellness of people with DM2 and a benefit for the institution, by innovating the schemes of directed care.

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Most cited references 29

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The costs of diabetic foot: the economic case for the limb salvage team.

Vickie R Driver, Matteo Fabbi, Lawrence A Lavery … (2010)

In 2007, the treatment of diabetes and its complications in the United States generated at least $116 billion in direct costs; at least 33% of these costs were linked to the treatment of foot ulcers. Although the team approach to diabetic foot problems is effective in preventing lower extremity amputations, the costs associated with implementing a diabetic foot care team are not well understood. An analysis of these costs provides the basis for this report. Diabetic foot problems impose a major economic burden, and costs increase disproportionately to the severity of the condition. Compared with diabetic patients without foot ulcers, the cost of care for patients with a foot ulcer is 5.4 times higher in the year after the first ulcer episode and 2.8 times higher in the second year. Costs for the treatment of the highest-grade ulcers are 8 times higher than for treating low-grade ulcers. Patients with diabetic foot ulcers require more frequent emergency department visits, are more commonly admitted to hospital, and require longer length of stays. Implementation of the team approach to manage diabetic foot ulcers within a given region or health care system has been reported to reduce long-term amputation rates from 82% to 62%. Limb salvage efforts may include aggressive therapy, such as revascularization procedures and advanced wound healing modalities. Although these procedures are costly, the team approach gradually leads to improved screening and prevention programs and earlier interventions, and thus seems to reduce long-term costs. To date, aggressive limb preservation management for patients with diabetic foot ulcers has not usually been paired with adequate reimbursement. It is essential to direct efforts in patient-caregiver education to allow early recognition and management of all diabetic foot problems and to build integrated pathways of care that facilitate timely access to limb salvage procedures. Increasing evidence suggests that the costs for implementing diabetic foot teams can be offset over the long-term by improved access to care and reductions in foot complications and in amputation rates. Copyright © 2010 Society for Vascular Surgery and the American Podiatric Medical Association. Published by Mosby, Inc. All rights reserved.