Journal List > J Korean Acad Community Health Nurs > v.30(4) > 1140692

Kim and Seo: Effects of Diabetic Foot Care Education for the Aged with Low Health Literacy

Abstract

Purpose

The purpose of this study was to examine the effects of diabetic foot care education for the older adults with low health literacy.

Methods

A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The participants who were diagnosed with diabetes, were adults over 65 years old at the welfare center of Y and B city. They were divided into the experimental group (n=32) and the control group (n=31). Inclusion criteria were a score of 5 or under on the Short form of Korean Functional Health Literacy Test and 24 or more on the Korean version of Mini-Mental State Examination. Foot care education was conducted in a small group for 40 minutes, once a week, for three weeks. The education materials are composed of an easy term, picture and photographs to understand easily.

Results

The scores of diabetic foot care knowledge (t=4.57, p<.001), foot care self-efficacy (t=6.07, p<.001), and foot self-care behavior (t=4.18, p<.001) were significantly increased in the experimental group compared to the control group. Foot health status was not significantly improved.

Conclusion

The findings indicate that this education program can be used as a nursing intervention improving foot care knowledge, foot care self-efficacy, and foot self-care behavior in order to prevent the diabetic foot problems of elderly diabetic persons with low health literacy.

References

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Table 1.
Foot Care Education for the Aged with Low Health Literacy
Session Topic Content Method Time (minute)
1 Diabetes mellitus 1. Introduction to the program Lecture 40
2. What is Diabetes Mellitus? Demonstration
3. What is Insulin?
4. Glucose
5. Diabetic complications
6. Diabetes management
7. Questions and answers
2 Diabetic foot care I 1. Diabetic foot ulcer Lecture 40
2. Foot care necessity Demonstration
3. Foot observation method
4. Foot care method
5. When you need to visit a hospital
6. Questions and answers
3 Diabetic foot care II 1. Foot massage Demonstration 40
2. Foot exercise Training
3. Questions and answers
Table 2.
Homogeneity Test of Characteristics and Dependent Variables between Experimental and Control Group (N=63)
Characteristics Categories Exp. (n=32)
Cont. (n=31)
x2 or t p
n (%) or M±SD n (%) or M±SD
General characteristics Age (year) 65~69 7 (21.9) 2 (6.5) 6.08 .113
70~74 9 (28.1) 6 (19.4)
75~79 11 (34.4) 11 (35.5)
≥80 5 (15.6) 12 (38.7)
Gender Male 2 (6.3) 7 (22.6) .082
Female 30 (93.8) 24 (77.4)
Education ≤Middle school 17 (53.1) 12 (38.7) 1.49 .497
High school 12 (37.5) 16 (51.6)
≥University 3 (9.4) 3 (9.7)
Disease related characteristics Duration of disease (year) <5 9 (28.1) 4 (12.9) 3.52 .340
5~9 5 (15.6) 9 (29.0)
10~14 8 (25.0) 6 (19.4)
≥15 10 (31.3) 12 (38.7)
Diabetic medication Yes 29 (90.6) 30 (96.8) .613
No 3 (9.4) 1 (3.2)
Diabetic neuropathy Yes 1 (3.1) 1 (3.2) >.999
No 31 (96.9) 30 (96.8)
History of diabetic foot Yes 0 (0.0) 1 (3.2) .492
No 32 (100.0) 30 (96.8)
Dependent variables Diabetic foot knowledge 10.91±2.84 10.13±2.03 1.25 .218
Diabetic foot care self-efficacy 42.69±7.69 41.74±5.88 0.55 .586
Diabetic foot self-care behavior 44.28±6.75 46.68±6.20 1.47 .148
  6 point scale (9 items) 31.41±5.56 32.77±6.25 0.92 .362
  4 point scale (5 items) 12.88±2.30 13.90±1.83 1.96 .055
Foot health status
  Claw condition Normal 14 (43.8) 17 (54.8) 0.78 .379
Abnormal 18 (56.2) 14 (45.2)
  Skin condition Normal 21 (65.6) 22 (71.0) 0.21 .649
Abnormal 11 (34.4) 9 (29.0)
  Foot formation Normal 31 (96.9) 30 (96.8) >.999
Abnormal 1 (3.1) 1 (3.2)
  Dorsal pedis artery Normal 32 (100.0) 31 (100.0) >.999
  pulsation Abnormal 0 (0.0) 0 (0.0)
  Foot sense Normal 23 (71.9) 22 (71.0) 0.01 .936
Abnormal 9 (28.1) 9 (29.0)

Cont.=control group; Exp.=experiment group;

Fisher's exact test.

Table 3.
Comparison of Program Effects between Experimental and Control Group (N=63)
Variables Groups Pretest
Posttest
Difference
t p
M±SD M±SD M±SD
Diabetic foot care knowledge Exp. (n=32) 10.91±2.84 14.38±1.29 3.47±3.06 4.57 <.001
Cont. (n=31) 10.13±2.03 10.74±2.13 0.61±1.75
Diabetic foot care self-efficacy Exp. (n=32) 42.69±7.69 54.78±6.18 12.09±9.78 6.07 <.001
Cont. (n=31) 41.74±5.88 41.87±4.93 0.13±5.26
Diabetic foot self-care behavior Exp. (n=32) 44.28±6.75 54.53±6.33 10.25±8.69 4.18 <.001
Cont. (n=31) 46.68±6.20 49.26±7.67 2.58±5.58
  6 point scale (9 items) Exp. (n=32) 31.41±5.56 37.34±5.45 5.94±7.83 2.56 .013
Cont. (n=31) 32.77±6.25 34.55±6.60 1.77±4.59
  4 point scale (5 items) Exp. (n=32) 12.88±2.30 17.19±2.72 4.31±3.22 4.37 <.001
Cont. (n=31) 13.90±1.83 14.71±2.91 0.81±3.15

Cont.=control group; Exp.=experiment group.

Table 4.
Comparison of Program Effects on Diabetic Foot Health Status between Experimental and Control Group (N=63)
Characteristics Categories Exp. (n=32)
Cont. (n=31)
x2 p
n (%) n (%)
Claw condition Normal 24 (75.0) 20 (64.5) 0.82 .365
Abnormal 8 (25.0) 11 (35.5)
Skin condition Normal 27 (84.4) 25 (80.6) 0.15 .697
Abnormal 5 (15.6) 6 (19.4)
Foot formation Normal 31 (96.9) 28 (90.3) .355
Abnormal 1 (3.1) 3 (9.7)
Dorsal pedis artery Normal 32 (100.0) 31 (100.0) >.999
Abnormal 0 (0.0) 0 (0.0)
Foot sense Normal 29 (90.6) 22 (71.0) .060
Abnormal 3 (9.4) 9 (29.0)

Cont.=control group; Exp.=experiment group;

Fisher's exact test.

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