Effectiveness of a Transtheoretical Model-Based Foot Care Program in Improving Foot Care Behaviors and Self-Efficacy in Adults With Type 2 Diabetes

Kes, Duygu; Sahin, Fatime; Ozkan, Aysegul Ertinmaz; Basmaz, Seda Erem

doi:10.1891/rtnp-d-21-00006

Cited by 2 publications

(5 citation statements)

References 21 publications

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“…The 29 eligible RCTs included 3891 participants from 16 countries, with sample sizes of 40 to 749 participants, and had follow-up durations ranging from 2 weeks to 26 months. Five studies recruited participants with active foot ulcers, 25,32,37,48,49 six trials included past ulcer amongst the inclusion criteria, 30,33,35,36,40,45 one trial included participants with ESRF and in the remaining trials the reporting of inclusion and exclusion criteria was very limited but did suggest high-risk participants were included (Table 1 and Table S2). Overall 12 trials were considered to have included participants at high risk of DFD [25][26][27]30,32,[34][35][36][37][38]40,48,49 (Table 1).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Of 2424 unique records identified from the search strategy, 74 underwent full‐text review, and 29 were found to be eligible for inclusion (Figure 1 and Table ) 21–49 . The 29 eligible RCTs included 3891 participants from 16 countries, with sample sizes of 40 to 749 participants, and had follow‐up durations ranging from 2 weeks to 26 months.…”

Section: Resultsmentioning

confidence: 99%

“…One trial with high‐risk participants 32 and two trials with lower risk participants 24,44 reported that the education intervention tested did not significant improve DFD knowledge. Nineteen of 20 trials reported the education programs significantly increased participant DFD self‐care behaviours but meta‐analysis was not possible due to heterogeneity in measurement tools used (for example the Foot Self‐Care Behaviour Scale and the Foot Care Practices Questionnaire) 21,22,24,27–29,31–35,38,39,41,42,44–47,49 . One trial with lower risk participants found no significant improvement in DFD self‐care behaviours 24 .…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 14 trials were deemed to be at high risk of bias, 23,24,26,29,30,32,34,36,37,42,45,[47][48][49] 14 as having some risk of bias, 21,22,25,27,28,31,33,[38][39][40][41]43,44,46 and only one as low risk of bias (Figure 2). 35 A high risk of bias was commonly identified with the methods of randomisation, lack of allocation concealment, inappropriate analyses, missing data, and uncertainty on the integrity of DROVANDI ET AL.…”

Section: Risk Of Bias Of Included Trialsmentioning

confidence: 99%

“…Nineteen of 20 trials reported the education programs significantly increased participant DFD self-care behaviours but metaanalysis was not possible due to heterogeneity in measurement tools used (for example the Foot Self-Care Behaviour Scale and the Foot Care Practices Questionnaire). 21,22,24,[27][28][29][31][32][33][34][35]38,39,41,42,[44][45][46][47]49 F I G U R E 2 Risk of bias outcomes for each randomised controlled trial included.…”

Section: Modifiable Cardiovascular Risk Factorsmentioning

confidence: 99%

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Effectiveness of educational interventions for diabetes‐related foot disease: A systematic review and meta‐analysis

Drovandi,

Seng,

Golledge

2023

Diabetes Metabolism Res

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This systematic review and meta‐analysis pooled evidence from randomised controlled trials (RCTs) on the effectiveness of educational programs for people with or at risk of diabetes‐related foot disease (DFD). A systematic search identified RCTs evaluating the effectiveness of educational programs in preventing or managing DFD. The primary outcome was risk of developing a foot ulcer. Secondary outcomes included any amputation, mortality, changes in cardiovascular risk factors, foot‐care knowledge and self‐care behaviours. Meta‐analyses were performed using random effects models. Risk of bias was assessed using Cochrane's ROB‐2 tool. Education programs were tested in 29 RCTs (n = 3891) and reduced risk of a foot ulcer by approximately half although the upper 95% confidence interval (CI) reached 1.00 (odds ratio [OR], OR 0.54; 95% CI 0.29, 1.00, I2 = 65%). Education programs reduced risk of any amputation (OR 0.34; 95% CI 0.13, 0.88, I2 = 38%) and HbA1c levels (standardized mean difference −0.73; 95% CI −1.26, −0.20, I2 = 93%) without affecting all‐cause mortality (OR 1.09; 95% CI 0.57, 2.07, I2 = 0%). Education programs mostly significantly improved DFD knowledge (13 of 16 trials) and self‐care behaviour scores (19 of 20 trials). Only one trial was deemed at low risk of bias. Previously tested education programs have mostly effectively improved participants' knowledge and self‐care behaviours and reduced risk of foot ulceration and amputation. Larger high quality trials with longer follow‐up are needed.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Risk Of Bias Of Included Trialsmentioning

confidence: 99%

Section: Modifiable Cardiovascular Risk Factorsmentioning

confidence: 99%

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Effectiveness of educational interventions for diabetes‐related foot disease: A systematic review and meta‐analysis

Drovandi,

Seng,

Golledge

2023

Diabetes Metabolism Res

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The effect of trans-theoretical model stage-matched intervention on medication adherence in hypertensive patients

Saeidi,

Ghavami,

Shahsavari

et al. 2024

Front. Cardiovasc. Med.

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IntroductionHypertension is a chronic condition that requires active patient management and awareness of treatment strategies. This study aimed to evaluate the effectiveness of an intervention program grounded in the Transtheoretical Model (TTM) of behavior change for improving treatment adherence among hypertensive patients.Materials and methodsThis study conducted at the Nukan Comprehensive Rural Health Center in Kermanshah, Iran, 120 participants were selected according to specific inclusion criteria. Demographic data and responses to 20 hypertension-related behavior questions were collected via a questionnaire. Participants were categorized into non-adherence (pre-contemplation, contemplation, preparation stages) and adherence categories (action and maintenance stages) based on self-reported medication adherence, with 60 individuals in each group. Each group was then randomly divided into intervention and control subgroups. The educational intervention consisted of four 45 min sessions grounded in TTM constructs regarding to health-related behaviors including Physical activity, salt and oil intake, and fruit and vegetable consumption, and medication adherence. Three months post-intervention, a follow-up questionnaire evaluated the educational impact on treatment adherence. The McNemar test and Chi-square test were utilized to analyze effects across the intervention, control, and pre- and post-intervention groups.ResultsThe participants had a mean age of 58.09 years (SD = 11.85). Three months after the intervention, the non-adherence intervention group showed significant progress in transitioning to the action and maintenance stages across all physical activity behaviors, as well as in salt, oil, fruit and vegetable intake, and medication adherence (P < 0.005). In the adherence intervention group, after the intervention, the number of hypertensive patients who fell into the action and maintenance categories according to all lifestyle variables increased, but the change was not significant. Concerning blood pressure, the intervention group had a significant reduction in mean systolic blood pressure (142.88 ± 20.87 vs. 141.00 ± 18.52; p = 0.015), but the decrease in mean diastolic blood pressure was not significant (88.17 ± 10.30 vs. 87.58 ± 9.70; p = 0.154). No significant changes in systolic or diastolic blood pressure were observed in the control or in intervention groups within the adherence category.ConclusionThis research highlights the potential benefits of applying the TTM to tailor interventions for hypertensive patients with poor treatment adherence, suggesting that such an approach can enhance the efficacy of health education interventions.

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Effectiveness of a Transtheoretical Model-Based Foot Care Program in Improving Foot Care Behaviors and Self-Efficacy in Adults With Type 2 Diabetes

Cited by 2 publications

References 21 publications

Effectiveness of educational interventions for diabetes‐related foot disease: A systematic review and meta‐analysis

Effectiveness of educational interventions for diabetes‐related foot disease: A systematic review and meta‐analysis

The effect of trans-theoretical model stage-matched intervention on medication adherence in hypertensive patients

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