The Effect of Foot Care Education for Patients with Diabetes on Knowledge, Self-Efficacy and Behavior: Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to synthesize randomized controlled trials on the impact of foot care education on knowledge, self-efficacy and behavior in patients with diabetes. A search was made using PubMed, Web of Science, Science Direct, Google Scholar, YOK National Thesis Center and Google Scholar electronic databases for studies published between March 2003-January 2022. The search medical subject headings (MeSH) terms were diabetic foot, knowledge, self-efficacy, and behavior. Studies suitable for the systematic review and the meta-analysis met the following criteria (PICOS): target participants would be diagnosed with diabetes (population), diabetic foot education (intervention), comparison of the group receiving diabetic foot care education and routine care education, and the control group receiving only routine care education (comparison), studies evaluating the levels of knowledge, self-efficacy and behavior (outcome), randomized controlled trials (study design). Twenty-six studies were included in systematic review. Three studies for knowledge, 5 studies for behavior, 8 studies for self-efficacy were included in the meta-analysis (total sample: 2534, experiment: 1464, control: 1071). All of the studies had low reporting bias. The mean duration of educations for knowledge was 5.2 months. This duration was 4.8 months for behavior and 4.5 months for self-efficacy. In the random effect (since the homogeneity test: P < .001, this model was used), there were significantly difference in terms of knowledge (standardized mean difference (SMD): 1.656, 95% [CI]: 1.014-2.299, P < .001), and behavior (SMD: 1.045, 95% CI: 0.849-1.242, P < .001). But no difference was observed in terms of self-efficacy (SMD: 0.557, 95%CI: −0.402-1.517, P > .05). The results of a systematic review of twenty-six studies and a meta-analysis of 9 studies showed that diabetic foot education improved the level of knowledge and behavior of patients with diabetes, while not affecting their self-efficacy. Educational interventions with long-term follow-up are needed to address the growing health care needs of patients with diabetes.

The Impact of Foot Care Education on Knowledge of Prevention the Risk for Diabetic Ulcers Among Diabetic Patients

“…Educational interventions with long-term follow-up are necessary to address the increasing health care needs of patients with diabetes (Yıldırım Ayaz et al, 2022).…”

“…The results of a systematic review of twenty-six studies and a meta-analysis of 9 studies show that diabetic foot education increases the level of knowledge and behavior of patients with diabetes. Educational intervention with long-term followup is necessary to address the increasing health care needs of patients with diabetes (Yıldırım Ayaz et al, 2022).…”

Using Near-Infrared Spectroscopy and Education to Support Older Adults with Diabetic Foot Ulcers to Age-in-Place: A Case Series

“…[13][14][15]18 The reduction of DFUs and their associated complications are enhanced when screening is more widespread and regularly completed. 5,13,22,23 Barriers to care, such as lack of transportation, financial burdens, and limited access to foot care, were removed by the RN and RSW completing inhome visits. 24 The in-home visits created a positive, trusting environment that focused on a holistic approach to older adult care.…”

“…Research shows that improved screening for DFUs could result in long-term cost savings and increased QoL for older adults 13–15,18 . The reduction of DFUs and their associated complications are enhanced when screening is more widespread and regularly completed 5,13,22,23 . Barriers to care, such as lack of transportation, financial burdens, and limited access to foot care, were removed by the RN and RSW completing in-home visits 24 .…”

Autumn’s Golden Leaves

“…Aagaard et al 4 provide the evidence on advantages and disadvantages of exercise therapy for patients with diabetic foot ulcers (DFUs). Yıldırım Ayaz et al 5 have carried out a systematic review and meta-analysis on the beneficial effects of foot care education in terms of subjects’ behaviour. Nancy et al 6 summarise current evidence on diagnosis, evaluation and treatment of pressure ulcers.…”