ORCID Profile
0000-0001-8044-3554
Current Organisation
Applied Science Private University
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Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/20420188221142457
Abstract: Patients’ adherence to using knee-high offloading treatment is critical to effective healing of diabetes-related foot ulcers (DFUs). Previous studies have found that patients generally have low adherence to using removable knee-high offloading treatments, yet no study has investigated whether their adherence differs during daytime and nighttime. This study aimed to investigate the levels and factors associated with adherence to using knee-high removable cast walker (RCW) treatment during daytime and nighttime weight-bearing activities in people with DFUs. This was a secondary analysis of data collected from a multi-centre cross-sectional study investigating adherence to using knee-high RCWs among 57 participants with DFUs. All participants had multiple socio-demographic, physiological and psychosocial factors collected, before having their adherence to using RCWs during weight-bearing activity monitored over a 1-week period using the dual activity monitor method. Adherence data were categorised into daytime (06:00–18:00) and nighttime (18:00–06:00) periods and calculated separately. Multiple linear regression was used to identify factors associated with daytime and nighttime adherence. Mean adherence to using RCW during weight-bearing activities in people with DFUs was higher during daytime compared with nighttime [39.9% (SD = 18.9) versus 20.4% (SD = 16.7), p 0.001]. Factors independently associated with lower adherence during daytime were being male, longer diabetes duration, not having peripheral artery disease (PAD), and higher perceived RCW heaviness. Factors associated with lower adherence during nighttime were higher mean daytime steps, not having retinopathy and having dyslipidaemia. Adherence to using RCWs during weight-bearing activities reduced significantly at nighttime compared with daytime among people with DFUs, and this was associated with different factors. Interventions to improve adherence, in research and clinical practice, should incorporate methods to target daytime or nighttime adherence specifically.
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJDRC-2021-002640
Abstract: Adherence to using knee-high offloading treatment is critical for healing diabetes-related foot ulcers (DFUs). However, few studies have investigated patients’ adherence to using knee-high offloading treatment. We aimed to investigate the levels and factors associated with adherence to using knee-high removable cast walker (RCW) treatment among patients with DFUs. In this multicenter cross-sectional study, we investigated adherence to using knee-high RCWs in 57 participants with DFUs. All participants were clinically examined for multiple sociodemographic, physiological, and psychosocial factors. Each participant’s adherence level to using RCWs was then objectively measured using dual activity monitors (attached to the wrist and RCW) over a 1-week period. Multiple linear regression was undertaken to determine those factors independently associated with adherence levels. The mean adherence level to using RCWs was 33.6% (SD 16.5) of weight-bearing activity. Factors independently associated with lower adherence levels were being male, longer diabetes duration, not having peripheral artery disease (PAD), and having higher perceived RCW heaviness (p≤0.05). No associations were found with psychosocial factors. Patients with DFUs adhered to using their RCWs on average for only a third of their prescribed weight-bearing treatment duration. Factors linked to lower RCW adherence levels were being male, longer diabetes duration, not having PAD, and perceived heavier RCWs. These findings highlight the importance of using gold standard non-removable knee-high offloading device treatment. Furthermore, these findings suggest, when gold standard devices are containdicated, that these factors be considered when prescribing the second choice RCW offloading treatment to optimise adherence. Regardless, further longitudinal studies are needed to confirm these factors.
Publisher: Queensland University of Technology
Publisher: Bentham Science Publishers Ltd.
Date: 03-04-2023
DOI: 10.2174/1573399819666230403132241
Abstract: Toenail onychomycosis is common in patients with diabetes and it can increase the risk of secondary infections and foot complications. Despite several studies investigating the prevalence and associated factors of toenail onychomycosis from different parts of the world, there are no data from Jordan. Todetermine the prevalence and the associated factors of toenail onychomycosis among patients with diabetes in Jordan. A cross-sectional study was conducted on 375 patients with diabetes at the National Centre for Diabetes, Endocrinology, and Genetics in Amman, Jordan. Several socio-demographic and health-independent variables including foot self-care practices were collected. Toenail onychomycosis was assessed by a specimen culture and microscopic examinations. Descriptive and inferential statistics were used for data analysis. The prevalence of toenail onychomycosis was 57.6% (n=216). Multiple logistic regression revealed four significant associated factors the presence of neuropathy (β=1.87, p=0.02), being an ex-smoker (β=2.69, p=0.01), being treated by both insulin and oral hypoglycemics drugs (β=1.32, p=0.03), and using antibiotics in the last year (β=1.78, p=0.02). The prevalence of toenail onychomycosis among patients with diabetes in Jordan is high. Regular foot screening and podiatric care are recommended especially among patients with diabetic neuropathy, current treatment by insulin and oral hypoglycemics drugs, previous history of smoking, and previous use of antibiotics.
Publisher: Bentham Science Publishers Ltd.
Date: 12-05-2020
DOI: 10.2174/1573399815666191001101910
Abstract: To determine the prevalence of, and factors associated with, people with foot deformities, among patients with diabetes in Jordan. A cross-sectional study was conducted on 1000 diabetic participants recruited from the National Center for Diabetes, Endocrinology, and Genetics in Jordan. Participants had their feet clinically examined to detect the following foot deformity outcomes: Hallux valgus, claw/hammer toe, prominent metatarsal heads, limited joint mobility, pes cavus, Charcot foot, and utations. Sociodemographic and health variables were also collected from participants’ interviews, medical records, or clinical examination. Logistic regression was used to analyse associations between variables and each foot deformity outcome. Of the 1000 diabetic patients: Hallux valgus was found in 17.4%, claw\\hammer toe in 16%, prominent metatarsal head in 14.2%, limited joint mobility in 9.4%, pes cavus in 3.2%, Charcot foot in 2.1%, and utations in 1.7%. Hallux valgus was associated with gender (p=0.012), age (p .01) and shoe choices (p=0.031) claw\\hammer toe was associated with age (p=0.04), retinopathy (p .001), sensory and painful neuropathy (p .001) limited joint mobility was associated with age only (p=0.001) Charcot foot was associated with glycemic control (p=0.016), hypertension (p .000), sensory neuropathy (p .001), and painful neuropathy (p .001) and, utations were associated with duration of diabetes (p .043), sensory neuropathy (p=0.001), and painful neuropathy (p=0.001). Prevalence of different foot deformities in Jordan variedbetween 1.7% - 17.4%. Sociodemographic factors such as age, gender and shoes choices or presence of diabetes-related microvascular complications (neuropathy and retinopathy) or hypertension were independently associated with foot deformities among the Jordanian diabetic population.
Publisher: MDPI AG
Date: 30-04-2023
DOI: 10.3390/S23094423
Abstract: Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test–retest reliability. Validity was tested using Pearson’s r and Bland–Altman tests, and reliability using Cohen’s kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60–100) vs. 35% (19–47), p 0.01). There was fair agreement (r = 0.46 p 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, p 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36 p 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures.
Publisher: SAGE Publications
Date: 07-05-2021
DOI: 10.1177/15347346211016699
Abstract: The main aims of this study were cross-cultural adaptation and reliability testing of an Arabic version of Foot Care Confidence Scale (FCCS), Foot Care Outcomes Expectations Scale (FCOES), Patient Interpretation of Neuropathy Scales (PINS), Neuropathy-specific Quality of Life Scales (NQOLS), and offloading-related Visual Analog Scales (VAS). Two phases of translation and reliability testing were conducted in Jordan. Phase 1 included 2 forward and backward translations with 2 panel consensuses (translators, clinicians, and experts). In Phase 2, Cronbach’s alpha ( α) and intraclass correlation coefficient (ICC) were used to test the internal consistency and stability (test–retest) of the Arabic scales in a s le of a total of 90 Jordanian participants with diabetic foot ulcers. Phase 1 resulted in Arabic translation and cross-cultural adaptation of the study scales. Phase 2 resulted in acceptable internal consistency of the translated scales ( α = 0.74-0.91), except for the PIN “self ractitioner blame” and “acute ulcer onset” scales ( α = 0.57, 0.49, respectively). Test–retest results (ICC) were: FCCS (0.85) FCOES (0.78) PINS (0.043-0.85) NQOLS (0.76-0.90) and offloading-related VAS (0.43-0.90). This study showed evidence of cultural appropriateness and reliability of most of the translated scales, for possible future implementation for the Arabic population.
No related grants have been discovered for Anas Ababneh.