Nurse-led education programme enhancing foot care self-efficacy in high-risk diabetes population: pilot randomised controlled study
DOI:
https://doi.org/10.1179/2057331615Z.0000000009Keywords:
Diabetic foot, self-efficacy, education, nursingAbstract
AbstractAims
The purpose of this study was to evaluate of a 5-week nurse-led educational programme on foot care self-efficacy in high-risk diabetic patients with current foot ulcers.
Methods
A pilot randomised controlled study was conducted in five acute care hospitals in Switzerland. Nineteen subjects (16 males and 3 females, aged 44–84 years) were randomly assigned to receive foot care education or standard care. Included were patients with diabetes, aged 18 years or older and in treatment for ulceration and/or amputation of the lower limp. The primary outcome measure was the development of foot care self-efficacy determined by the Foot Care Confidence Scale questionnaire (FCCS). The outcome was assessed 5 weeks after randomisation and education.
Results
The results demonstrated that an evidence-based education programme for high-risk patients can promote short-time foot care-related self-efficacy. While the group comparison showed no significant difference between the groups before and after the intervention, there was a significant difference in self-efficacy comparing the change of the FCCS from baseline to Week 5. Self-efficacy in the intervention group (IG) (M = 9.5, SD ±7.6) was significantly enhanced compared to the control group (CG) (M = 0.64, SD ±8.4, t(17) = 2.4, p = 0.031, r = 0.5). The FCCS score in the IG was significantly higher after the intervention (T = 0, p = 0.02, r = 0.5) compared to the CG after 5 weeks (T = 26.5, p = 0.92, r = 0.02).
Conclusions
This pilot study demonstrated that nurses successfully accomplish interventions to enhance foot care-related self-efficacy. It is therefore necessary that nurses continue taking such important supporting roles. A larger study, however, is needed to confirm this preliminary data.
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References
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217–28.
Abbott CA, Vileikyte L, Williamson S, Carrington AL, Boulton AJ. Multicenter study of the incidence of and predictive risk factors for diabetic neuropathic foot ulceration. Diabetes Care. 1998;21(7):1071–5.
Apelqvist J, Larsson J, Agardh CD. Long-term prognosis for diabetic patients with foot ulcers. J Intern Med. 1993;233(6):485–91.
Apelqvist J, Larsson J. What is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab Res Rev. 2000;16(Suppl. 1):S75–83.
Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, et al. Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006;45(5 Suppl.):S1–66.
Valk GD, Kriegsman DM, Assendelft WJ. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev. 2008;1:CD001488.
Malone JM, Snyder M, Anderson G, Bernhard VM, Holloway GA, Jr., Bunt TJ. Prevention of amputation by diabetic education. Am J Surg. 1989;158(6):520–3; discussion 523–4.
Lincoln NB, Radford KA, Game FL, Jeffcoate WJ. Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial. Diabetologia. 2008;51(11):1954–61.
Sloan HL. Developing and testing of the Foot Care Confidence Scale. J Nurs Meas. 2002;10(3):207–18.
University of Michigan Diabetes Research and Training Center. Michigan Neuropathy Screening Instrument (MNSI). Michigan: University of Michigan Health System; 2000.
Lincoln NB, Jeffcoate WJ, Ince P, Smith M, Radford KA. Validation of a new measure of protective footcare behaviour: the Nottingham Assessment of Functional Footcare (NAFF). Pract Diab Int. 2007;24(4):207–11.
Perrin BM, Swerissen H, Payne C. The association between foot-care self-efficacy beliefs and actual foot-care behaviour in people with peripheral neuropathy: a cross-sectional study. J Foot Ankle Res. 2009;2:3.
Keller-Senn A, Imhof L. 2011. Der diabetische Fuss: Ursachen und Warnsignale. Winterthur: Zürcher Hochschule für Angewandte Wissenscahften, Departement Gesundheit, Institut für Pflege - Forschung & Entwicklung Pflege.
Keller-Senn A, Imhof L. 2011. Der diabetische Fuss: Vorsorge - Was können Sie selber tun? Winterthur: Zürcher Hochschule für Angewandte Wissenscahften, Departement Gesundheit, Institut für Pflege - Forschung & Entwicklung Pflege.
Registered Nurses Association of Ontario. Nursing Best Practice Guideline: Reducing Foot Complications for People with Diabetes. 2007:90. http://www.rnao.org/Storage/33/2735_Reducing_foot_complications_-_final.pdf (accessed 01 May 2009).
Almaraz MC, Gonzalez-Romero S, Bravo M, Caballero FF, Palomo MJ, Vallejo R, et al. Incidence of lower limb amputations in individuals with and without diabetes mellitus in Andalusia (Spain) from 1998 to 2006. Diabetes Res Clin Pract. 2011;95(3):399–405.
Fujiwara Y, Kishida K, Terao M, Takahara M, Matsuhisa M, Funahashi T, et al. Beneficial effects of foot care nursing for people with diabetes mellitus: an uncontrolled before and after intervention study. J Adv Nurs. 2011;67(9):1952–62.
Dorresteijn JA, Kriegsman DM, Assendelft WJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev. 2010;5:CD001488.
Dorresteijn JA, Valk GD. Patient education for preventing diabetic foot ulceration. Diabetes Metab Res Rev. 2012;28(Suppl. 1):101–6.
Lamers F, Jonkers CC, Bosma H, Knottnerus JA, van Eijk JT. Treating depression in diabetes patients: does a nurse-administered minimal psychological intervention affect diabetes-specific quality of life and glycaemic control? A randomized controlled trial. J Adv Nurs. 2011;67(4):788–99.
Loveman E, Royle P, Waugh N. Specialist nurses in diabetes mellitus. Cochrane Database Syst Rev. 2003(2):CD003286.
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