Page 223 - Hospital Authority Convention 2018

Service Enhancement Presentations

F8.2 Young HA Investigators Session 14:30 Room 421

The Effect of Person-centred Diabetic Foot Care Education on Self-Efficacy and Foot Care Behaviour in People
with Diabetes: A Randomised Controlled Trial
1
Chan EYL , Sit WHJ 2
2
1 Podiatry Department, Hong Kong East Cluster, Hospital Authority, The Nethersole School of Nursing, The Chinese University HOSPITAL AUTHORITY CONVENTION 2018
of Hong Kong, Hong Kong
Introduction
Diabetic foot care (DFC) education is the cornerstone of diabetic foot ulcerations (DFU) prevention. DFC education was
provided by healthcare professionals with a long history, but the prevalence of DFU is still high. Reviews suggested that this
may be due to the absence of individualised approach in scaffolding the contents. A new person-centred DFC education
guided by health-belief model was therefore designed with its effectiveness evaluated.

Objectives
To evaluate the effect of DFC education programme using health-belief model on self-efficacy and foot care behaviour in
people with diabetes.

Methodology
A randomised control trial was conducted in 288 diabetic patients who first attended Hong Kong East Cluster Podiatry
Departments. Participants were randomly assigned to experimental (EG) or control (CG) group. Participants in EG received
individual session on person-centred, health-belief model guided DFC education during their first podiatry appointment
(T0). Their risk of DFU, barriers of performing DFC task were highlighted and resolved accordingly. Their home care plan
in DFC were also monitored in two telephone follow-up sessions in week four and week eight. For CG, they received usual
DFC education during their first podiatry appointment and two telephone calls in week four and eight in order to balance the
psychological effects of professional contact.
Data collections were conducted before the DFC education of both groups (T0) and at 12th week after intervention.
Sociodemographic data sheet and validated DFC efficacy and behaviour instruments were completed. Objective data in
bilateral hallux length and thickness, callosity stiffness, severity of xerosis and tinea pedis were measured by independent
assessors who were blind to group allocation.

Descriptive statistics and generalised estimating equation model were used for data analysis.

Results
231 patients completed the study (dropout rate was 19.8%). There were significant improvements between EG and CG in
DFC self-efficacy (p=0.001), preventive behaviour (p=0.001), damaging behaviour (p=0.018) and bilateral hallux toenail length
(p=0.024). There was no significant difference between EG and CG in other variables.

Diabetic foot care education using health-belief model was found beneficial to people with diabetes in terms of DFC efficacy
and behaviours. Clinicians should review their current DFC education programme and consider to adopt person-centred
approach to advocate the importance of DFC and DFU prevention. Tuesday, 8 May 2018

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