Factors related to hospital‐to‐home transitional self‐monitoring blood glucose behaviour among patients with diabetes‐related foot ulcer. Issue 6 (29th April 2021)

• Record Type: Journal Article
• Authors: Chin, Yen‐Fan; Huang, Tzu‐Ting; Yu, Hsing‐Yi; Yang, Hui‐Mei; Hsu, Brend Ray‐Sea
• Is Part Of: International journal of nursing practice. Volume 27:Issue 6(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-04-29
• Subjects: blood glucose -- diabetes mellitus -- foot ulcer -- nursing -- patient discharge -- self‐care -- self‐efficacy -- transitional care; Nursing -- Periodicals; Nursing -- Practice -- Periodicals; 610.73092
• DOI: 10.1111/ijn.12950
• Languages: English
• ISSNs: 1322-7114

Abstract

Abstract: Aims: To explore the factors related to hospital‐to‐home transitional self‐monitoring blood glucose behaviour among patients with diabetes‐related foot ulcer. Background: The 30‐day readmission rate of patients with diabetes‐related foot ulcer can be reduced when good glycaemic control is achieved. The practice of self‐monitoring blood glucose promotes optimal glycaemic control. Design: A comparative descriptive study. Methods: In this study, 200 participants, who had been hospitalized due to diabetes‐related foot ulcer, were recruited from August 2017 to July 2018. Before participants were discharged from the hospital, psychosocial factors (family support, threat belief, self‐efficacy and knowledge) and pre‐hospitalization self‐monitoring blood glucose behaviour were collected using a structured questionnaire. Then, after discharge, self‐monitoring blood glucose behaviour delivery was collected again. Results: Five variables explained 47% of the variance in the delivery of self‐monitoring of blood glucose at home. The delivery of hospital‐to‐home transitional self‐monitoring blood glucose behaviour was more likely for individuals with higher pre‐discharge self‐efficacy, higher post‐discharge self‐efficacy, more attention to pre‐hospitalization glycaemic status and post‐discharge insulin usage and those without an insensitive foot. Conclusion: Self‐monitoring blood‐glucose behaviour should be promoted among post‐discharge patients with diabetes‐related foot ulcer. The modifiable factors identified in this study can be integrated into the discharge plan. Summary statement: What is already known about this topic? Patients with diabetes‐related foot ulcer have higher 30‐day readmission rates than the general inpatient population. Such readmissions can be prevented when good glycaemic control is achieved. As a centrepiece of diabetes self‐management, self‐monitoring blood glucose practice promotes optimal glycaemic control. Although there have been several survey studies of self‐monitoring blood glucose practice among patients with diabetes, to our knowledge, no study has used longitudinal data to explore the self‐monitoring of blood glucose behaviour. In addition, no study has explored hospital‐to‐home transitional self‐monitoring of blood glucose among patients with diabetes. What this paper adds? After participants were discharged from the hospital, approximately one‐fourth did not perform self‐monitoring of blood glucose at home. The delivery of hospital‐to‐home transitional self‐monitoring blood glucose practice was more likely for individuals with higher pre‐discharge self‐efficacy, higher post‐discharge self‐efficacy, more attention to pre‐hospitalization glycaemic status and post‐discharge insulin usage as well as for those without an insensitive foot. Self‐efficacy of self‐monitoring of blood glucose is the most powerful predictor of hospital‐to‐home transitional self‐monitoring blood‐glucose practice. The implications of this paper: For patients with less attention paid to their glycaemic status previously and with impaired foot sensation, an intensive discharge plan should be provided to promote their self‐monitoring blood‐glucose practice. To promote self‐monitoring blood‐glucose practice, strategies to improve self‐efficacy related to self‐monitoring of blood glucose should be integrated into the discharge plan and subsequent follow‐up.