Cuidados realizados por estomaterapeutas no atendimento a pessoas idosas com pé diabético

Abstract

The aging process is associated with the presence of diabetes and its complications, resulting in functional impairment, since these impair the elderly person’s ability to evaluate and perform self-care and self-protection of the diabetic foot. It is essential to provide multidisciplinary assistance to the elderly, among which, we highlight the caregiver, a professional qualified to perform specific care with the diabetic foot. This study aims to know the care performed by stomatizers in the care of elderly people with diabetic foot. This is a cross-sectional study conducted in the five regions of Brazil (North, Northeast, South, Southeast and Midwest), from April to July 2021. The population was composed of nurses working in the care of elderly people with diabetic foot. Sampling occurred by stratification, which was initiated by members associated with the Brazilian Association of Stomatiapia: Stomachaches, Wounds and Incontinence. The instrument for data collection was an electronic questionnaire, sent by email, Lattes platform and made available on social media (Whatsapp, Instagram, Facebook, Linkedin), composed of 48 questions that included variables related to the characterization of the sample, professional training and evaluation of functional capacity, tissue repair and diabetic foot in the elderly. For data analysis, the nominal variables were described by simple and relative frequency, and for numerical variables, the median and interquartile range of 75% (IQR) were presented. Bivariate analyses and logistic regression were performed, considering associations with p<0.05 as significant. In addition, the strength of association was also observed through the Odds Ratio (OR) and the 95% Confidence Interval (95%CI). The analyses were performed in the Stata 13 program. Regarding the factors associated with the care of elderly people with diabetic foot by stomatizers as to age, professionals with a higher age group investigated more about daily measurement of foot temperature; low income as a barrier in diabetic foot care; the use of 10 g monofilament and hammer for neurological evaluation of the diabetic foot; evaluation of nail dystrophy, daily foot hygiene, straight cutting of nails and guidance by means of booklets. As for professional experience in diabetes, there was a statistically significant association with investigation of hearing deficit as a barrier to diabetic foot care; pain intensity; use of the 128Hz tuning fork in the clinical examination of the diabetic foot and evaluation of dermatological manifestations during the clinical examination of the foot. In addition, specialists with longer professional experience investigate more about the inability to perform personal hygiene, inability to self-care, frequency of return for clinical examination of the feet of patients without gravity, identification of dermatological manifestations, nail dystrophy, interdigital maceration, inspection of the shoe and use of emollients. It is concluded that, although the sample of this study is directed to stomatiuts, professionals qualified to deal with skin lesions, respecting the life cycle of patients, as well as based on scientific knowledge and skills, showed good performance in diabetic foot care, however, the peculiarities of being elderly were not integrated into the care, evidencing notorious fragmentation between the diabetic foot and the person with this condition, with impaired comprehensive care.