수용개작방법을 활용한 당뇨인의 발관리 실무지침 개발
Development of Clinical Practice Guideline by Adaptation:Diabetic Foot Care
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연구목적: 본 연구는 우리나라 상황을 고려하여 지침을 개발하는 수용개작(adaptation)방법에 따라 예방과 관리에 초점을 둔‘당뇨인의 발관리’실무지침을 개발하고자 하였다. 연구방법: 본 연구는 한국보건의료연구원 임상진료지침 지원국에서 발간한 ‘임상진료지침 수용개작 매뉴얼’에 따라 수용개작의 방법을 이용하였으며, 이는 3부, 9모듈, 23단계로 구성되어 있다. 연구결과: 수용개작 방법으로 개발된 ‘당뇨인의 발관리’ 실무지침은 머리글, 당뇨병성 발질환, 권고 요약, 권고, 참고문헌, 부록, 용어의 순으로 구성되었다. 총 권고수는 165개이며, 4개의 중영역(당뇨병성 발궤양 위험사정과 예방전략, 당뇨병성 발궤양 상처사정과 관리전략)으로 구성되었다. 권고등급은 A가 30개(18.2%), B가 8개(4.8%), C가 30개(18.2%), 그리고, D가 97개(58.5%)이었다. 결론: 본 연구에서 개발된 실무지침은 의료인이나 당뇨인의 발관리를 위한 교육자료로 활용될 수 있다. 또한, 본 연구에서 개발된 실무지침이 의료기관이나 지역사회에서 의료인의 실무향상을 위해 활용될 수 있다.
Abstract
This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.
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