Diabetes research and clinical practice · 2025
Instruments for measuring diabetic foot self-care behavior: a systematic review of measurement properties.
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Siregar Deborah, Adif Shannastaniar Aisya, Lam Le Trinh, Yen Miaofen, Lee Huan-Fang
Аннотация
AIMS: To synthesize and critically evaluate the psychometric properties of patient-reported outcome measures (PROMs) designed to assess diabetic foot self-care behaviors.
METHODS: A systematic search was conducted in PubMed, EMBASE, CINAHL, and Cochrane databases up to February 2024. Eligible studies included adults (≥18 years) with diabetes who could independently perform daily foot care, and only instruments assessing self-reported foot care practices were included. Studies were excluded if diabetes was not the primary condition, instruments were unrelated, or full-text data were unavailable. The methodological quality and measurement properties of these instruments were assessed using the COSMIN checklist and a modified GRADE approach.
RESULTS: Seven self-report instruments for assessing diabetic foot self-care were identified across 16 studies. The review found considerable variability in the methodological quality and psychometric robustness of the included PROMs. The Diabetic Foot Self-Care Questionnaire (DFSQ) consistently showed adequate content validity, structural validity, and internal consistency, and was validated across several cultural context.
CONCLUSION: Despite generally adequate psychometric properties, the evidence is limited by small and variable sample sizes, lack of longitudinal data, incomplete cross-cultural representation, and potential publication bias. Overall, the DFSQ demonstrated the most robust psychometric properties and recommended as a reliable and valid tool for assessing diabetic foot self-care behaviors in both research and clinical practice.
METHODS: A systematic search was conducted in PubMed, EMBASE, CINAHL, and Cochrane databases up to February 2024. Eligible studies included adults (≥18 years) with diabetes who could independently perform daily foot care, and only instruments assessing self-reported foot care practices were included. Studies were excluded if diabetes was not the primary condition, instruments were unrelated, or full-text data were unavailable. The methodological quality and measurement properties of these instruments were assessed using the COSMIN checklist and a modified GRADE approach.
RESULTS: Seven self-report instruments for assessing diabetic foot self-care were identified across 16 studies. The review found considerable variability in the methodological quality and psychometric robustness of the included PROMs. The Diabetic Foot Self-Care Questionnaire (DFSQ) consistently showed adequate content validity, structural validity, and internal consistency, and was validated across several cultural context.
CONCLUSION: Despite generally adequate psychometric properties, the evidence is limited by small and variable sample sizes, lack of longitudinal data, incomplete cross-cultural representation, and potential publication bias. Overall, the DFSQ demonstrated the most robust psychometric properties and recommended as a reliable and valid tool for assessing diabetic foot self-care behaviors in both research and clinical practice.