الفهرس 
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Abstract
Diabetes mellitus, a metabolic disorder characterized by elevated blood glucose, is a serious and growing problem. Diabetes is associated with high rates of hospitalization, blindness, renal failure and non-traumatic amputation. In cases where lower extremity amputation is required, health care (Mustafa, Iqbal, Pravez, 2017).
Diabetes is a Global epidemic and worldwide disease. Diabetic effects various system of the body, one of those is foot. “A diabetic foot ulcer (DFU) is any full-thickness wound below the ankle in a diabetic patient, irrespective of duration. People with diabetes are 15 times more likely to undergo a lower-extremity amputation than their non-diabetic counterpart. Diabetic foot problem cause increase morbidly and mortality. Incident of Diabetic foot can be reduced by identifying various risk factors and by patient’s education (Ahmed, Asif, Saleem, Abdulmajeed, 2017).
People with poor knowledge and practice of foot care had higher incidence of foot ulcers and adoption of foot care practices has shown to reduce foot problems among diabetic patients. Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation (Deepa et al., 2017).
Aim of the study:
The aim of this study was to assess the factors affecting healing process of diabetic foot ulcer among diabetic patients.
Research question:
What are the factors affecting healing process of diabetic foot ulcer?
Subjects and methods:
Research design
The study was descriptive exploratory study.
Setting:
The study was conducted in general surgical department, ICU, and outpatient clinics in Al-arish General Hospital.
Subjects:
The sample of the study was consisted of (75) patients with diabetic foot ulcer. The sample included in this study included in this study is fulfilling the following criteria:
Inclusion criteria:
A Purposive sample of adult patients with diabetic foot ulcer, type 1and type 2 diabetes mellitus from both genders who agreed to participate in the study.
Exclusion criteria:
Patients diagnosed with arterial occlusion and admitted in the hospital for treated re-vascular were excluded from this study.
Tools of data collection:
The data were collected through using the following tool:
Tool 1: Patient interviewing questionnaire (Appendix I) it included five parts:
This part including the following:
Part 1: Patient’s demographic characteristics.
Part 2: patient clinical health status.
Part 3: Data related to treatment regimen.
Part 4: Data related to wound.
Part 5: Interviewing Patient’s knowledge questionnaire: Concerning with assessing present patients’ level of knowledge regarding to disease process, developed by Garciaca and Association, (2001).
Tools 2: Foot care practice questionnaire (appendix II)
Used a diabetic foot care questionnaire designed by (Bijoy et al., 2012; Pollock et al., 2004).
Tools 3: Wagner classification system (Appendix III):
Used to assess wound grade by using Wagner classification, was developed by Wagner, (1987).
Tools 4: Thai stress test (TST) questionnaire; (Appendix IIII)
It was adapted from psychiatric association Thailand, (2000).
Results:
The study results indicated one third of study subjects aged between 50≥60 years, half of study subjects were male and obese and, less than half of them had bachelor level of education.
The current study showed majority of studied patients had type 2and poor glycemic control. Two thirds of studied patients had diabetes from 10 years. Nearly three quarter of subjects were come from rural.
The study results indicated that more than half of patients in the study had high stress level and one third of them had average stress.
Less than half of patients in the study needed amputation, one third of them needed surgical debridement and less than one quarter healed without amputation.
Regarding to total knowledge more than half of patients in the study had unsatisfactory knowledge about diabetes.
Regarding to patient’s level of practice more than half of patients in the study had good practice toward diabetic foot care.
Factors affecting healing of diabetic foot ulcer
Statistically significant relationship between diabetic foot ulcer healing, debridement, or amputation regarding their age and sex (demographic characteristics).
Statistically significant relationship between diabetic foot ulcer healing, debridement or amputation regarding their infection (wound characteristics).
Statistically significant relationship between diabetic foot ulcer healing, debridement, or amputation regarding their debridement, offloading device and type of dressing (treatment regimen).
Statistically significant relationship between diabetic foot ulcer healing, debridement or amputation regarding their wound grade.
Statistically significant relationship between diabetic foot ulcer healing, debridement or amputation regarding their level of mental stress.
Recommendation:
Developing a simplified and disseminate comprehensive booklet including basic information about caring of diabetes patients.