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Holistic care of patients with diabetic foot ulcers during the COVID-19 era: integration of Henderson's Need Theory

11 August 2022
15 min read
Volume 31 · Issue 15


The COVID-19 pandemic has inhibited the practice of diabetic foot ulcer care, particularly in the community. Comprehensive theory-based nursing care is needed to prevent further complications. Unfortunately, a study combining theory with nursing care in diabetic foot ulcer care has not been explored. When caring for patients with diabetic foot ulcers, who are also at increased risk of severe complications from COVID-19, it is important to take a holistic view of the patient and consider all of their needs and the factors affecting them. Henderson's Need Theory and the 14 basic needs contained within it was chosen to be integrated in the care of patients with diabetic foot ulcers during the pandemic, with the hope that the findings will help nurses to optimise care in both hospital-based and community practice.

As of 17 July 2022, the World Health Organization (WHO) reported more than 559 million cumulative cases of COVID-19 with more than 6 million deaths globally (WHO, 2022). The rapidly changing situation has impacted healthcare delivery including diabetes care (Schofield et al, 2020); access to outpatient clinics has been limited to prevent outbreaks (Peric and Stulnig, 2020). The COVID-19 pandemic has presented challenges, particularly for patients with foot ulcer complications (Yunir et al, 2022). Furthermore, psychological issues were also found in times of pandemics including emotional distress and psychosocial disintegration (Mukhtar and Mukhtar, 2020).

These clinical manifestations pose new challenges in diabetic foot ulcer (DFU) care. Therefore, a comprehensive approach is needed to prevent the long-term effects of COVID-19 in patients with DFUs. An investigation described ‘the double triage, double buffer, and dual mode’ model and the process for treatment of DFUs in hospitals in China (Tao et al, 2020). Rogers et al (2020a) proposed a Pandemic Diabetic Foot Triage System in order to reduce complications, while Meloni et al (2020) also found that a triage pathway helps the health professional in delivering DFU care during the COVID-19 pandemic. Using an algorithm for surgical intervention prevents the negative impact of COVID-19 infection in people with diabetes (Kelahmetoglu et al, 2020). Kamal et al (2021) designed a hospital bed specifically for diabetic foot care, and there is lots of scope for health technology to be optimised in delivering care for patients with a chronic illness (such as DFUs) (Nabilla et al, 2021).

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