اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

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کد مقاله 1501

عنوان Evidence on the Effects of Telenursing Interventions on Complete Healing, Healing Time, and Amputation in Patients with Diabetic Foot Ulcers: A Narrative Review

نویسندگان Soheil Ranjbari

چکیده Background: Diabetic foot ulcer is a common, disabling, and costly complication of diabetes mellitus, requiring regular follow-up and continuous access to specialized wound care. However, geographical barriers, limited nursing resources, and the financial burden of repeated outpatient visits may restrict patients’ access to continuous care. Telenursing interventions have emerged as a potential approach to bridge this gap, and various clinical trials and qualitative studies have examined their effectiveness and acceptability. This narrative review aimed to summarize the available evidence on the effects of telenursing interventions on three key clinical outcomes: complete wound healing, time to healing, and amputation in patients with diabetic foot ulcers. Method: PubMed and Google Scholar were searched using the keywords telenursing, telemedicine, diabetic foot ulcer, wound healing, and amputation. Studies were included when nurses had a central role in remote monitoring, consultation, or decision-making, whether the intervention was designed as telenursing or telemedicine. Randomized controlled trials, including individual and cluster trials, one quasi-experimental study, one participatory action research study, and one complementary qualitative study were reviewed, and findings were thematically synthesized Finding: Quantitative evidence indicates that remote monitoring of diabetic foot ulcers is comparable to conventional outpatient care in terms of complete healing rates and healing time. Amputation rates generally showed no significant difference, although one pretest-posttest study reported a gradual reduction in wound severity and no amputations. Qualitative evidence further suggests that the success of these interventions depends not solely on technology; nurses’ confidence in clinical decision-making, effective integration of technology into routine workflows, and attention to patients’ individual needs and preferences are important factors influencing their acceptance and real-world effectiveness. Conclusion: Telenursing interventions may be an effective approach comparable to standard care for managing diabetic foot ulcers. Their successful implementation requires attention to nurses’ and patients’ needs and experiences, appropriate technological infrastructure, and systematic consideration of preventive strategies. Further high-quality clinical trials with longer follow-up are needed to establish more definitive conclusions.

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