ผลของการใช้นวัตกรรมกระจกส่องเท้าต่อความถูกต้อง ในการประเมินแผลจำลองที่เท้าผู้ป่วยเบาหวานด้วยตนเอง

Kallapungha Chosivasakul; Chosita Visuthisa; Nualchan Poolgate; Chalermporn Tangkittrungerung; Warangkana Taapasanan

Authors

Kallapungha Chosivasakul Boromarajonani College of Nursing, Bangkok, Faculty of Nursing, Praboromrajchanok institute
Chosita Visuthisa Phra Samut Chedi Sawatyanon Hospital
Nualchan Poolgate Phra Samut Chedi Sawatyanon Hospital
Chalermporn Tangkittrungerung Phra Samut Chedi Sawatyanon Hospital
Warangkana Taapasanan Phra Samut Chedi Sawatyanon Hospital

Keywords:

foot inspection mirror, diabetic foot ulcer, effectiveness, innovation

Abstract

Introduction: Diabetic foot ulcers (DFU) are a major complication of diabetes that can lead to severe infection and limb loss. Self-assessment of foot ulcers is important, and using a foot inspection mirror may help overcome the limitations when bending or lifting the foot during inspection.

Research objectives: To evaluate the effect of a foot inspection mirror on the accuracy of self-assessing simulated foot ulcers in patients with diabetes.

Research methodology: This was a quasi-experimental study with one-group, pretest-posttest design. The sample consisted of 46 patients with type 2 diabetes receiving care at Phra Samut Chedi Sawatyanon Hospital, Samut Prakan Province, Thailand. The foot inspection mirror was developed using the Plan-Do-Check-Act (PDCA) process and underwent quality testing. It features a 2× magnification mirror and an extendable handle. The instruments used in this study included plantar-view photographs, ulcer simulation stickers, and foot ulcer location assessment form. Data were collected using a demographic questionnaire, the foot ulcer location assessment form, and a satisfaction survey, evaluating the usability, benefits, and appropriateness of the equipment. Data were analyzed using descriptive statistics, and a paired sample t-test was used to compare the mean accuracy scores for foot ulcer location assessment before and after using the innovation

Results: The mean accuracy score for the simulated foot ulcer location assessment was significantly higher after using the foot inspection mirror than before its use (p < .001). Satisfaction regarding usability and benefits of the device was rated at the highest level (M = 47.69 and 48.50), respectively.

Conclusions: The foot inspection mirror, equipped with 2× magnification mirror and an extendable handle, enables patients with diabetes to inspect the simulated wounds on the plantar surface and within the interdigital spaces more easily and clearly.

Implications: This innovation can be developed for use in more diverse populations. Further long-term studies are recommended to evaluate its clinical efficacy in reducing the actual incidence of DFUs.

Downloads

Download data is not yet available.

References

Duncan BB, Magliano DJ, Boyko EJ. IDF diabetes atlas 11th ed. 2025: Global prevalence and projections for 2050. Nephrology, Dialysis, Transplantation: Official Publication of The European Dialysis and Transplant Association - European Renal Association. 2025. doi: 10.1093/ndt/gfaf177

Charoendee K, Boriboon N, Butchumsaeng A, Rungrueang S. Annual Report 2023. Non-Communicable Disease Division, Department of Disease Control, Ministry of Public Health [Internet]. 2023 [cited 2025 Mar 11]. Available from: https://ddc.moph.go.th/dncd/news.php?news=41556&deptcode

Registered Nurses Association of Ontario (RNAO). Diabetic foot ulcers: Prevention, assessment and management. 3rd ed. Toronto (ON): Registered Nurses’ Association of Ontario (RNAO); 2024.

Rinkel WD, Luiten J, van Dongen J, Kuppens B, Van Neck JW, Polinder S, Castro Cabezas M, Coert JH. In-hospital costs of diabetic foot disease treated by a multidisciplinary foot team. Diabetes Research and Clinical Practice 2017;132:68-78. doi: 10.1016/j.diabres.2017.07.029.

Wongsin U, Chiangchaisakultha K, Suanrueang P, Thumwanna P, Changprajuck N. Cost Analysis of cold plasma for wound care among patients with type 2 diabetes mellitus in thai community hospitals. Journal of Health Policy Law and Administration 2026;12(2):289-97. (in Thai)

Vanherwegen AS, Lauwers P, Lavens A, Doggen K, Dirinck E. Sex differences in diabetic foot ulcer severity and outcome in Belgium. PLoS One 2023;18(2):e0281886. doi: 10.1371/journal.pone.0281886

Ojo O, Boateng J, Pacella R, Hanrahan A, Essex R, Dibley L. Factors influencing the care and management of diabetic foot ulcers: A scoping review. Endocrine practice: Official Journal of The American College of Endocrinology and The American Association of Clinical Endocrinologists 2025;31(3):380–9.

Untari EK, Andayani TM, Yasin NM, Asdie RH. A review of patients’ knowledge and practice of diabetic foot self‑care. The Malaysian Journal of Medical Sciences 2024;31(1):33–50.

Singh A, Raj R, Kannauje PK, Das P, Meher J, Routray M. Diabetic foot care education and practices: A knowledge, attitudes, and practices questionnaire‑based study. Cureus 2025;17(6):e85436. doi: 10.7759/cureus.85436

Rahim MA, Azad M, Begum M, Devnath H, Nisha Z. Nursing interventions for the prevention and management of diabetic foot ulcers among patients at Rajshahi Medical College Hospital. Scholars Journal of Applied Medical Sciences 2024;12(6):768-75.

Tangcheewinsirikul K. An understanding of diabetic foot self-care practice among type 2 diabetic patients of Chalermprakiat Hospital in Buri Ram Province. Medical Journal of Srisaket Surin Buriram Hospitals 2022;37(3):569-78. (in Thai)

Mahathamnuchock S, Phanpeang P, Keelapang A. A study on the self-foot examination practice among diabetes patients, Mae Hong Son Province. Journal of Bamrasnaradura Infectious Diseases Institute 2022;16(1):22-32.

Akça Doğan D, Enç N. The effect of using a reminder diabetic foot mirror on foot checking frequency and development of diabetic foot in people with diabetes. International Journal of Diabetes in Developing Countries 2022;42:321–30. doi: 10.1007/s13410-021-00985-x

Khunkaew S, Fernandez R, Sim J. Health-related quality of life and self-care management among people with diabetic foot ulcers in Northern Thailand. SAGE Open Nursing 2019;1-10. doi: 10.1177/2377960819825751

Brown R, Ploderer B, Da Seng LS, Lazzarini P, Van Netten J. MyFootCare: A mobile self-tracking tool to promote self-care amongst people with diabetic foot ulcers [Internet]. In: Brereton M, Vyas D, Soro A, Ploderer B, Waycott J, Morrison A, editors. Proceedings of the 29th Australian conference on computer-human interaction: Human-nature, OzCHI 2017. New York: Association for Computing Machinery; 2017 [cited 2025 Oct 15]. p.462-6. Available from: https://eprints.qut.edu.au/114116/

Nextdoor Doctors Bangkok, Thai PBS. Mirror protector for diabetic foot patients: Tonthong Sub-district Health Promoting Hospital, Mueang District, Lamphun Province. 2016 [cited 2025 Mar 15]. Available from: https://www.thaipbs.or.th/program/NextdoorDoctors/episodes/37801

Public Health Service Center 38. Innovative foot mirror for diabetic patients [Internet]. 2018 [cited 2025 Mar 15]. Available from: https://www.youtube.com/watch?v=zWvoSR5Tzs8

Suksongkram S. The concept of the Deming Cycle (PDCA) with the administration in the way of Buddhism. Journal of Thammawat 2021;2(1):39-49. (in Thai)

Keery MS. Long handled mirror: A daily skin check inspection tool [Internet]. 2024 [cited 2025 Sep 30]. Available from: https://thediytherapist.com/long-handled-mirror-a-diabetes-daily-skin-check-inspection-tool

Train The Brain Forum Committee. Thai Mental State Examination (TMSE). Siriraj Hospital Gazette, 1993;45(6):359-74. (in Thai)

Prestige Medical Care Health Care Excellence. Using a mirror for diabetic foot care [Internet]. 2025 [cited 2025 Oct 7]. Available from: https://prestigemedicalaz.com/using-a-mirror-for-diabetic-foot-care/

Kanan P, Siribumrungwong B, Tharavanij T, Orrapin S, Napunnaphat P. The needs of patients with diabetes for the prevention and treatment of foot complications in Thailand: A qualitative descriptive study. Belitung nursing journal 2023;9(6):586-94. doi: 10.33546/bnj.2835.