ArticleFrontiers in endocrinology2026
Impact of a three-subject, dual-track, interactive care model on hospitalized patients with diabetic foot.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Diabetic foot (DF) is a severe chronic complication of diabetes, associated with high amputation risk and mortality. Conventional nursing often neglects patients' psychological needs and long-term self-management, limiting comprehensive rehabilitation. Interactive nursing has shown promise in chronic disease care, yet systematic evaluations of its multidimensional effects remain scarce. This study assessed a three-subject, dual-track, interactive care (TSDTIC) model on wound healing, psychological state, and quality of life in DF patients. Methods: This retrospective cohort study included 150 hospitalized DF patients (June 2021 - June 2024). Patients were assigned to groups based on the nursing care model implemented during their admission period: the RC group (n=84) comprised patients admitted between June 2021 and December 2022, and the TSDTIC group (n=66) comprised patients admitted between January 2023 and June 2024. The TSDTIC model was introduced as a structured quality improvement program in January 2023; therefore, group assignment was sequential rather than randomized. Baseline demographic and clinical characteristics were comparable between groups (all P > 0.05), and ANCOVA with baseline values as covariates was performed for continuous outcomes. Outcomes included wound improvement rate (based on area reduction), fasting and postprandial glucose, Hamilton Anxiety/Depression Scale (HAMA/HAMD) scores, SF-36 quality-of-life scores, and nursing satisfaction. Results: The TSDTIC group showed significantly higher wound improvement rate (95.45% vs. 82.14%, P = 0.013). Post-intervention, fasting (6.29 ± 1.05 vs. 7.94 ± 1.82 mmol/L, P<0.001) and postprandial glucose (8.92 ± 1.29 vs. 10.35 ± 1.41 mmol/L, P<0.001) were markedly lower in TSDTIC. HAMA (7.21 ± 2.13 vs. 10.02 ± 2.06) and HAMD (6.88 ± 2.06 vs. 10.26 ± 2.14) scores significantly improved (both P<0.001). All eight SF-36 dimensions were higher in TSDTIC (all P<0.001 after Bonferroni correction). Satisfaction rate was higher in TSDTIC (95.45% vs. 73.81%, P<0.001). Conclusion: The TSDTIC model was associated with improvements in short-term wound healing, glycemic control, mental health, and quality of life in DF patients. However, given the historical control design and lack of long-term outcomes, findings should be interpreted cautiously; prospective randomized trials are warranted.
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