| Summary: | Background: Foot ulceration and subsequent lower extremity amputation are common, serious, and expensive chronic complications for patients with diabetes. Foot-care education, provided to patients with diabetes at low-risk for ulcers, prevents minor foot problems that may lead to ulceration. Little evidence is available to support the effectiveness of educational intervention in low-risk diabetic patients.
Objectives: The objectives of the pilot study were to examine the feasibility and acceptability of the foot care educational intervention, and to explore its effects on patients’ foot self-care knowledge, efficacy, and behaviors, and the occurrence of minor foot problems in adult patients with diabetes at low risk for foot ulceration.
Methods: A one group repeated measures design was used. The intervention was given over a 3-week period. The first intervention session consisted of a 1-hour one-on-one, provider-patient interaction to discuss foot self-care strategies; the second session involved a 1-hour hands-on practice training. The third and fourth sessions entailed two 10-minute telephone contact booster sessions. Seventy eligible participants with type 2 diabetes at low risk for foot ulcerations were enrolled in the study, and 56 participants (30 women and 26 men; mean age: 55.8±13.2 years) completed the study. The outcomes of foot self-care knowledge, efficacy, behavior, and foot and footwear conditions were assessed at pre-test, following the first two sessions, and 3-month follow-up. Repeated measures analysis of variance, and paired-t test were used to examine changes in outcomes over time.
Results: The findings provided initial evidence suggesting the foot self-care educational intervention is feasible and acceptable to adult patients with type 2 diabetes. It was effective in improving patients’ foot self-care knowledge (F (2, 54) = 230.444, p < 0.01), self-efficacy (F (2, 54) = 94.668, p < 0.01), and foot self-care behaviors (t (55)=117.228, p < 0.01), in reducing the occurrence of minor foot skin and toenails problems (all p<0.05), and in improving wearing proper shoes and proper socks (all p<0.05 ) at 3-month follow-up.
Conclusions: The findings from this pilot study support the effects of the intervention. Future research should evaluate its efficacy using a randomized clinical trial design, and a large sample of patients with diabetes at low risk for foot ulcerations.
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