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已发表论文
基于清单管理模型的高危糖尿病足患者以患者为中心的每日足部自我护理方案开发：一项 Delphi 研究
Authors Lin X, Chen X, Li Y, He S, Xie H, Zhuo Y, Zhang L, Zhou X
Received 22 July 2025
Accepted for publication 15 December 2025
Published 3 February 2026 Volume 2026:19 545241
DOI https://doi.org/10.2147/DMSO.S545241
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Ernesto Maddaloni
Xiaodan Lin,1 Xianghao Chen,1 Yuantian Li,2 Shumin He,3 Haidan Xie,1 Yiting Zhuo,1 Leting Zhang,1 Xiaozhou Zhou4
1School of Nursing, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510315, People’s Republic of China; 2Department of Endocrinology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 3Wound and Ostomy Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 4Department of Nursing, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China
Correspondence: Xiaozhou Zhou, Department of Nursing, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19, Nonglinxia Road, Yuexiu District, Guangzhou, Guangdong Province, 510080, People’s Republic of China, Tel +86-13622268608, Email zhouxz819@163.com
Background: The International Diabetic Foot Working Group emphasizes that daily foot self-care is a critical measure for preventing diabetic foot ulcers, with patients serving as the primary implementers. However, there is a notable lack of patient-centered, specific, and actionable care management plans. This study aims to develop a scientifically sound, standardized, and practical daily foot self-care protocol for high-risk diabetic foot patients based on the checklist management model.
Methods: This study was conducted in two sequential phases. First,a preliminary draft of the foot self-care program was developed through a comprehensive literature review and semi-structured interviews with healthcare professionals and patients. Subsequently, from December 2024 to January 2025, the Delphi method was employed to conduct two rounds of expert consultation with 17 specialists, during which the indicators were screened and refined based on predefined criteria.
Results: In the first and second rounds of expert consultations, 18 and 17 questionnaires were distributed, respectively, with 17 valid responses returned each round, yielding effective response rates of 94.44% and 100%. The expert authority coefficient was 0.93, indicating high credibility. The Kendall’s harmony coefficients were 0.168 and 0.272 (p< 0.001), reflecting improved consensus across rounds. In the second round, the coefficient of variation ranged from 0 to 0.16, with all items below the 0.25 threshold. The final self-care plan comprises 5 primary indicators (self-foot examination, foot hygiene care, shoe and sock selection, daily precautions, and daily foot self-care flowchart) and 27 secondary indicators.
Conclusion: The self-care plan developed using the checklist management model is scientifically grounded, targeted, and feasible. It provides a structured basis for effective and standardized self-care among high-risk diabetic foot patients, However, it is essential to note that this protocol is still in the developmental stage and requires further clinical validation to assess its practical effectiveness and implementation feasibility.
Keywords: diabetes high-risk feet, self-care, checklist management model, Delphi method
1School of Nursing, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510315, People’s Republic of China; 2Department of Endocrinology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 3Wound and Ostomy Center, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China; 4Department of Nursing, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510080, People’s Republic of China
Correspondence: Xiaozhou Zhou, Department of Nursing, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19, Nonglinxia Road, Yuexiu District, Guangzhou, Guangdong Province, 510080, People’s Republic of China, Tel +86-13622268608, Email zhouxz819@163.com
Background: The International Diabetic Foot Working Group emphasizes that daily foot self-care is a critical measure for preventing diabetic foot ulcers, with patients serving as the primary implementers. However, there is a notable lack of patient-centered, specific, and actionable care management plans. This study aims to develop a scientifically sound, standardized, and practical daily foot self-care protocol for high-risk diabetic foot patients based on the checklist management model.
Methods: This study was conducted in two sequential phases. First,a preliminary draft of the foot self-care program was developed through a comprehensive literature review and semi-structured interviews with healthcare professionals and patients. Subsequently, from December 2024 to January 2025, the Delphi method was employed to conduct two rounds of expert consultation with 17 specialists, during which the indicators were screened and refined based on predefined criteria.
Results: In the first and second rounds of expert consultations, 18 and 17 questionnaires were distributed, respectively, with 17 valid responses returned each round, yielding effective response rates of 94.44% and 100%. The expert authority coefficient was 0.93, indicating high credibility. The Kendall’s harmony coefficients were 0.168 and 0.272 (p< 0.001), reflecting improved consensus across rounds. In the second round, the coefficient of variation ranged from 0 to 0.16, with all items below the 0.25 threshold. The final self-care plan comprises 5 primary indicators (self-foot examination, foot hygiene care, shoe and sock selection, daily precautions, and daily foot self-care flowchart) and 27 secondary indicators.
Conclusion: The self-care plan developed using the checklist management model is scientifically grounded, targeted, and feasible. It provides a structured basis for effective and standardized self-care among high-risk diabetic foot patients, However, it is essential to note that this protocol is still in the developmental stage and requires further clinical validation to assess its practical effectiveness and implementation feasibility.
Keywords: diabetes high-risk feet, self-care, checklist management model, Delphi method