Effectiveness of a theory-based foot care education program (3STEPFUN) in improving foot self-care behaviours and foot risk factors for ulceration in people with type 2 diabetes

Diabetes Res Clin Pract. 2019 Jun:152:29-38. doi: 10.1016/j.diabres.2019.05.003. Epub 2019 May 10.

Abstract

Aims: To evaluate the effectiveness of a theory-based foot care education intervention program (3STEPFUN) for people with type 2 diabetes at low risk of developing a foot ulcer.

Methods: A controlled, pre-test/ post-test quasi-experimental design was used. From 119 participants, 60 participants in the control group received usual care and a foot care brochure. Those in the intervention group received (1) a small group intensive education and hands-on skills session; (2) a foot care kit and documents; and (3) three regular booster follow-up phone calls over 6 months. Generalised Estimating Equations models were undertaken to examine the impact of the intervention on outcomes over time.

Results: The intervention group had significantly improved outcomes compared to the control group over 6 months in the following aspects: improved preventive foot care behaviour (p = 0.001); and decreased prevalence of foot risk factors for ulceration (i.e. dry skin, corns/ callus) (OR: 0.04, 95% CI 0.01 - 0.13, p < 0.001).

Conclusions: The study's findings provide evidence of 3STEPFUN on improving foot self-care behaviour and preventing minor foot problems. Further study with formal RCT design and longer follow-up time to examine the effects on decreasing foot ulcer incidence is recommended.

Keywords: Diabetes; Education intervention; Foot self-care; Foot ulceration; Low-risk.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Diabetic Foot / prevention & control*
  • Female
  • Follow-Up Studies
  • Foot / pathology
  • Health Behavior* / physiology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Program Evaluation
  • Risk Factors
  • Self Care / methods*
  • Single-Blind Method