Research Article

Prevention and Management of Diabetes-Related Foot Ulcers through Informal Caregiver Involvement: A Systematic Review

Table 1

Eligibility criteria for studies.

PICOSInclusionExclusion

Participants(i) Persons with diabetes type 1 or 2, with or without diabetes-related foot ulcer and their informal caregiver (ICG).
(ii) Participants are persons 18 years and above.
(iii) ICGs in this review were defined as parents, spouse, friends, significant other, or any unpaid person providing and/or assisting patient with care activities at home.
(iv) The caregiver may or may not be residing with the patient but sees the patient on regular basis to assist with provision of care.
(v) In studies where caregiver participation is only optional, then, the data for those who participated with their ICG (Dyad) must have been presented separately for such studies to be included.
(i) Persons with diabetes but resident in a nursing care home and hostels since the caregiver ratios and relationship will be dissimilar to a traditional home environment.
(ii) Studies that not all participants participated with their caregivers and the data not presented separately for those who attended with their ICG.
(iii) Studies involving only caregivers without patients and vice versa
Intervention(i) Interventions or programs actively engaging patients and at least one component/session of the intervention involved the patient’s ICG, aimed at preventing and/or managing DFUs.
(ii) Prevention intervention refers to interventions or programs among persons with diabetes but without current DFU, and such interventions encourage or teach behaviors and practices that seeks to prevent patients from developing diabetes-related foot problems (see outcomes column).
(iii) DFU management interventions pertain to interventions for persons with diabetes who have got current diabetes-related foot ulcer/problems and such interventions seeks to treat or avert the existing foot problems.
(i) Interventions involving only caregivers without patients (persons with diabetes) and vice versa.
Context(i) Studies with their settings in hospitals, diabetic clinics, or communities in any part of the world.(i) Nursing homes, care/residential homes and hostels where persons with diabetes are residing and cared for by carers and other employees.
Outcome(i) Foot self-care behavior/practices (e.g., foot inspection, foot hygiene, nail care, appropriate footwear and socks, foot sensitivity checking, temperature checking., etc.).
(ii) Knowledge on diabetes
(iii) Glycated hemoglobin (HbA1c)
(iv) Incidence of foot problems (e.g., incidence of primary and/or recurrent diabetic foot ulcers, diabetic neuropathies, limb amputations, foot disability, callus, and tinea pedis)
(v) Wound size or wound healing
(i) Quality of life outcomes
(ii) Cost-related outcomes
Type of studies(i) Experimental design studies including randomized controlled trials (RCTs) and prepostdesign studies
(ii) Cluster-RCTs and quasiexperimental studies
(iii) Studies of any sample size, language, publication status, or setting were eligible
(i) Qualitative studies
(ii) Reviews
(iii) Methodological papers
(iv) Noninterventional or observational studies