International journal of nursing studies · 2025
The effect of a nurse-led health education intervention on treatment delay in patients with diabetic high-risk foot: A randomised controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Xie Yusheng, Liu Zhaoqing, Ming Yue, Wang Qiansha, He Kehuan, Nie Pu, Wang Zhuping, Huang Rongrong
Аннотация
BACKGROUND: Diabetic high-risk foot-the pre-ulcerative phase of diabetic foot disease-offers a critical window for prevention. Insufficient self-care and during this stage markedly increases ulcer risk, and once ulcers develop, treatment postponement precipitates infection, amputation, and death. Targeted education that enhances self-care and motivates prompt consultation is therefore essential, yet structured nurse-led healthcare-seeking programs specifically designed for diabetic high-risk foot remain scarce.
OBJECTIVE: To develop and evaluate the effects of a nurse-led health education program on treatment-seeking delay intention, actual delay behaviour, foot care knowledge, foot care behaviour, and self-efficacy among patients with diabetic high-risk foot.
DESIGN: Assessor-blind two-arm randomised controlled trial with a repeated-measures design.
SETTING: Participants were recruited from inpatients in the endocrinology and metabolism department of a university-affiliated hospital in Guizhou province, China.
PARTICIPANTS: A total of 70 patients with diabetic high-risk foot.
METHODS: Participants were randomised to an intervention group or a usual-care control group. The intervention group received a structured nurse-led program in addition to standard care, which comprised assessment, personalised risk and harm-perception education, foot-care behaviour guidance, delay-consequence alerts, and medical-care pathway planning, weekly classes and workshop sessions delivered during hospitalisation, with post-discharge support maintained through a WeChat-based platform. The control group received routine discharge education only. The data collection process spanned 12 months, with baseline (T0) collected pre-intervention, and follow-ups conducted at discharge (T1), 3 months (T2), 6 months (T3), and 12 months (T4). Outcomes included treatment delay intention, foot-care knowledge, behaviour, and self-efficacy; diabetic foot incidence and treatment timing were additionally recorded at T4. Data were analysed using generalised estimating equations to examine group, time, and interaction effects, with statistical significance set at p < 0.05.
RESULTS: Compared with controls, intervention participants demonstrated statistically significant improvements in treatment delay intention, foot-care knowledge, behaviour, and self-efficacy (p < 0.05). No statistically significant between-group difference was observed in diabetic-foot incidence (p > 0.05); however, among incident cases, delayed treatment was statistically significantly less frequent in the intervention group (p < 0.05).
CONCLUSIONS: The program was effective for improving foot care knowledge, behaviour, and self-efficacy among patients. Furthermore, it statistically significantly enhanced patients' intention to seek timely treatment and reduced the actual occurrence of treatment delay upon development of foot ulcer symptoms.
REGISTRATION: This study was registered at the Chinese clinical trial registry (ChiCTR2400083760) on April 30, 2024, and participant recruitment was initiated in June 2024.
OBJECTIVE: To develop and evaluate the effects of a nurse-led health education program on treatment-seeking delay intention, actual delay behaviour, foot care knowledge, foot care behaviour, and self-efficacy among patients with diabetic high-risk foot.
DESIGN: Assessor-blind two-arm randomised controlled trial with a repeated-measures design.
SETTING: Participants were recruited from inpatients in the endocrinology and metabolism department of a university-affiliated hospital in Guizhou province, China.
PARTICIPANTS: A total of 70 patients with diabetic high-risk foot.
METHODS: Participants were randomised to an intervention group or a usual-care control group. The intervention group received a structured nurse-led program in addition to standard care, which comprised assessment, personalised risk and harm-perception education, foot-care behaviour guidance, delay-consequence alerts, and medical-care pathway planning, weekly classes and workshop sessions delivered during hospitalisation, with post-discharge support maintained through a WeChat-based platform. The control group received routine discharge education only. The data collection process spanned 12 months, with baseline (T0) collected pre-intervention, and follow-ups conducted at discharge (T1), 3 months (T2), 6 months (T3), and 12 months (T4). Outcomes included treatment delay intention, foot-care knowledge, behaviour, and self-efficacy; diabetic foot incidence and treatment timing were additionally recorded at T4. Data were analysed using generalised estimating equations to examine group, time, and interaction effects, with statistical significance set at p < 0.05.
RESULTS: Compared with controls, intervention participants demonstrated statistically significant improvements in treatment delay intention, foot-care knowledge, behaviour, and self-efficacy (p < 0.05). No statistically significant between-group difference was observed in diabetic-foot incidence (p > 0.05); however, among incident cases, delayed treatment was statistically significantly less frequent in the intervention group (p < 0.05).
CONCLUSIONS: The program was effective for improving foot care knowledge, behaviour, and self-efficacy among patients. Furthermore, it statistically significantly enhanced patients' intention to seek timely treatment and reduced the actual occurrence of treatment delay upon development of foot ulcer symptoms.
REGISTRATION: This study was registered at the Chinese clinical trial registry (ChiCTR2400083760) on April 30, 2024, and participant recruitment was initiated in June 2024.