Problems that nurses confront in primary health care (in Kosovo) in relation to diabetic patients at risk from developing foot ulcers

Abstract

 

Background: In Kosovo, diabetes patients are diagnosed and classified based on WHO (1999) recommendations. Although in developed countries several clinical guidance on diabetes management, tools for identification of ‘at risk foot’ and ulcer classification schemes are available, none of them are used in Kosovo. Diabetes patients at risk of developing foot ulcers in Kosovo are identified based on risk factors asked during the check ups. Worldwide research on diabetic foot care has mainly focused on prevention, management of foot ulcers and barriers to the delivery of diabetic foot care, but nurses’ challenges related to diabetic foot care have received little attention.

Aim: The aim of the research is to identify and explore Kosovan nursing challenges in relation to diabetic patients at risk from developing foot ulcers.

Methodology: A qualitative exploratory research.

Methods: Research was conducted in Kosovo. Six nurses working in Primary Health Care were interviewed based on piloted Interview Guide. The data was analysed based on qualitative content analysis guided by constant comparative method of Strauss and Corbin (1998) analytical framework.

Findings: Seven categories and many subcategories were developed from the interviews conducted. The categories were: ‘Education (nurse and patient education)’; ‘Environmental constraints’; ‘Collaboration between professionals on foot care’; ‘Diabetic foot complications and their consequences’; ‘Professional autonomy’ and; ‘Absence of network in Health Care Settings’.

Conclusion: In conclusion it is argued that, the situation for Kosovo nurses working with diabetic patients at risk from developing foot ulcers is hopeless and is beyond their control. Regardless of their enthusiasm to work in the prevention of diabetes foot ulceration and in the identification of high risk patients’, nurses working in Diabetes Consultation Room/Wound Care Room face many barriers that challenge them to offer better foot care and to prevent diabetes foot ulcers.