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A systematic review of the impact of foot-care education on self-efficacy and self-care in patients with diabetes

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Title: A systematic review of the impact of foot-care education on self-efficacy and self-care in patients with diabetes
Authors: Goodall, R
Ellauzi, J
Tan, K
Onida, S
Davies, A
Shalhoub, J
Item Type: Journal Article
Abstract: Objectives: Assess the evidence supporting the impact of patient foot-care education on self-efficacy, self-care behaviour and self-care knowledge in individuals with diabetes. Design: Systematic review registered prospectively on the PROSPERO database (CRD42019106171). Materials and Methods: Ovid EMBASE and MEDLINE databases were searched from 1946 to end of March 2019, using search terms related to the domains diabetic foot, patient education, self-efficacy, self-care behaviour and self-care knowledge. All included studies were prospective, randomised controlled trials that assessed foot-care education interventions in individuals with diabetes and recorded an outcome related to self-efficacy, self-care behaviour and/or self-care knowledge. Results: 13 randomised controlled trials were included, reporting on a total of 3,948 individuals. The risk of bias was high or unclear in 11 of the 13 included studies, and low in 2 studies. Both the education-interventions delivered, and the outcome assessment tools used were heterogenous across included studies: meta-analysis was therefore not performed. Eight of 11 studies identified significantly better foot self-care behaviour scores in individuals randomised to education compared with controls. Self-efficacy scores were significantly better in education groups in four of five studies reporting this primary outcome. Foot-care knowledge was significantly better in intervention versus control in three of seven studies. In general, studies assessing secondary end-points including quality of life and ulcer/amputation incidence tended not to identify significant clinical improvements. Conclusion: The available evidence is of inadequate quality to reliably conclude that foot-care education has a positive impact on foot self-care behaviour and self-efficacy in individuals with diabetes. Quality data supporting accompanying benefits on quality of life or ulcer/amputation incidence are also lacking and should be considered as an important outcome measure in future studies.
Issue Date: 1-Aug-2020
Date of Acceptance: 31-Dec-2019
URI: http://hdl.handle.net/10044/1/76609
DOI: 10.1016/j.ejvs.2020.03.053
ISSN: 1078-5884
Publisher: Elsevier
Start Page: 282
End Page: 292
Journal / Book Title: European Journal of Vascular and Endovascular Surgery
Volume: 60
Issue: 2
Copyright Statement: © 2020 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Diabetes
Diabetic foot
Patient education
Self care behaviour
Self efficacy
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Cardiovascular System & Hematology
Publication Status: Published
Online Publication Date: 2020-07-11
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine



This item is licensed under a Creative Commons License Creative Commons