Effectiveness of a Theory-Based Foot Care Education Program on Self-Efficacy and Adaptation in Patients With Diabetes in Turkey: A Randomized Controlled Trial

BACKGROUND: Persons with diabetes often face significant foot problems due to inadequate foot care, and foot care training programs could be beneficial for these patients. PURPOSE: To examine the effects of diabetic foot care training on self-efficacy and adaptation based on Social Cognitive Theory and the Roy Adaptation Model. METHODS: In this randomized controlled study, 80 patients treated in the endocrine polyclinic of an education and research hospital in İzmir, Turkey, were randomized to intervention (n = 40) or control (n = 40). The intervention group received diabetic foot care training at 1 month, 3 months, and 6 months. Using a diabetic foot model, foot care training was given on diabetic foot care practices; in addition, a foot care training booklet prepared by the researchers was provided. Foot care behaviors, self-efficacy, and adaptation were reevaluated after the training and education. Data were collected at baseline, 1 month, 3 months, and 6 months in both groups. RESULTS: Diabetic foot care training and telephone follow-up were effective in improving foot care behaviors and facilitating the coping and adaptation process of individuals with diabetes, as well as in increasing their self-efficacy regarding foot care. CONCLUSIONS: When providing theory-based diabetic foot education, the use of visual materials along with verbal instruction as well as telephone follow-ups to evaluate training effectiveness increases patients' self-efficacy and adaptation.