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Master Thesis

Plaie du pied diabétique : étude qualitative des obstacles à l’observance de la décharge

Abstract : Diabetic foot ulcers are a common complication generating high care costs and causing serious repercussions for patients both psychologically and in terms of mortality and handicap prognosis. One key approach for treatment is off-loading the wound. The off-loading devices used may be irremovable (which allow for perfect patient compliance but are often counter-indicated and badlyexperienced by the patients) or, in most cases, removable (therapeutic footwear). We note that patient compliance with removable devices is low. In order to identify the factors for low patient compliance, we carried out a multi-centre qualitative study on Reunion island, by semi-structured interviews, involving 10 patients followed by the Diabetes-Endocrinology department for a diabetic foot wound (8 patients with open wounds and 2 patients with healed wounds) and who were prescribed an off-loading device. The data analysis we performed using the grounded theory method indicated factors related to the disease itself (weariness and loss of hope, anxiety or depression, external locus of control and fatalism), to the off-loading procedure (activity limitation, loss of autonomy) and to the off-loading footwear itself (aesthetic and impaired self-image concerns, loss of balance, laterality and implementation problems). The patients seem to be well informed and willing to follow the prescription. Help should be provided to overcome psychological barriers, practical difficulties and to involve patients in designing more precise care plans.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01445924
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, January 25, 2017 - 2:36:00 PM
Last modification on : Wednesday, August 23, 2017 - 4:30:55 PM
Long-term archiving on: : Wednesday, April 26, 2017 - 3:57:29 PM

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Candice Kembellec. Plaie du pied diabétique : étude qualitative des obstacles à l’observance de la décharge. Médecine humaine et pathologie. 2015. ⟨dumas-01445924⟩

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