J Korean Acad Community Health Nurs.  2019 Dec;30(4):560-570. 10.12799/jkachn.2019.30.4.560.

Effects of Diabetic Foot Care Education for the Aged with Low Health Literacy

• Kim H
• Seo JM

• KMID: 2467656
• DOI: http://doi.org/10.12799/jkachn.2019.30.4.560

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.

Keyword

Aged; Diabetic foot; Foot ulcer; Diabetes mellitus; Health education

Reference

References

1. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2017: Korea National Health and Nutrition Examination Survey (KNHANES Ⅶ-2) [Internet]. Seoul: Statistics Korea;2018. [cited 2018 December 28]. Available from. https://knhanes.cdc.go.kr/knhanes/sub04/sub04_03.do?classType=7.

2. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Annals of Medicine. 2017; 49(2):106–116. https://doi.org/10.1080/07853890.2016.1231932.

3. Schmader KE. Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. The Clinical Journal of Pain. 2002; 18(6):350–354. https://doi.org/10.1097/00002508-200211000-00002.

4. Pataky Z, Vischer U. Diabetic foot disease in the elderly. Diabetes & Metabolism. 2007; 33(1):S56–S65. https://doi.org/10.1016/s1262-3636(07)80057-7.

5. Pendsey SP. Understanding diabetic foot. International Journal of Diabetes in Developing Countries. 2010; 30(2):75–79.

6. Lee JK. Self-management and its predictors for patients with poorly controlled type 2 diabetes. The Journal of Korean Academic Society of Adult Nursing. 2009; 21(5):447–457.

7. Mitty E. Nursing care of the aging foot. Geriatric Nursing. 2009; 30(5):350–354. https://doi.org/10.1016/j.gerinurse.2009.08.004.

8. Speros C. Health literacy: Concept analysis. Journal of Advanced Nursing. 2005; 50(6):633–640. https://doi.org/10.1111/j.1365-2648.2005.03448.x.

9. Lee YM, Son YJ, Lee EJ. Health literacy, disease-related knowledge, self-efficacy and self-care behavior in patients with dia- betes mellitus. Journal of the Korean Data Analysis Society. 2012; 14(6):3087–3101.

10. Lee E-H, Lee YW, Moon SH. A structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life in patients with type 2 diabetes. Asian Nursing Research. 2016; 10(1):82–87. https://doi.org/10.1016/j.anr.2016.01.005.

11. Kim NH, Yang YR, Lee MH. Effects of health literacy and knowledge on diabetic self-care in the elderly with DM living alone. Journal of Korean Academy of Community Health Nursing. 2016; 27(4):370–379. https://doi.org/10.12799/jkachn.2016.27.4.370.

12. Park HJ, Hwang SK. Linguistic and functional health literacy among community-dwelling old adults. Global Health & Nursing. 2014; 4(2):49–58.

13. Kim SH, Lee E. The influence of functional literacy on perceived health status in Korean older adults. Journal of Korean Academy of Nursing. 2008; 38(2):195–203. https://doi.org/10.4040/jkan.2008.38.2.195.

14. Lee SJ, Song M, Im EO. Effect of a health literacy-Considered diabetes self-management program for older adults in South Korea. Research in Gerontological Nursing. 2017; 10(5):215–225. https://doi.org/10.3928/19404921-20170831-03.

15. Kim M. Development of diabetes education material for older people with low health literacy in rural community [dissertation]. [Muan]: Mokpo University;2018. p. 139.

16. Noh YS, Jeon SJ, Kwon YS, Im MS, Sim GH. Effects of foot care education on foot care compliance and diabetic foot complications in elders with diabetes. Journal of Korean Gerontological Nursing. 2007; 9(2):124–132.

17. Folstein MF, Folstein SE, Mchugh PR. "Mini-mental state": A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975; 12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6.

18. Kwon YC, Park JH. Standardization of Korean version of the mini-mental state examination (MMSE-K) for use in the elderly. part II: Diagnostic validity. Journal of the Korean Neuropsychiatric Association. 1989; 28(1):125–135.

19. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: A new instrument for measuring patient's literacy skills. Journal of General Internal Medicine. 1995; 10(10):537–541. https://doi.org/10.1007/bf02640361.

20. Kim SH. Validation of the short version of Korean functional health literacy test. International Journal of Nursing Practice. 2017; 23(4):e12559. https://doi.org/10.1111/ijn.12559.

21. Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah hospital, Lahore. Journal of Pakistan Medical Association. 2009; 59(10):687–690.

22. Sloan HL. Developing and testing of the foot care confidence scale. Journal of Nursing Measurement. 2002; 10(3):207–218. https://doi.org/10.1891/106137402780955020.

23. Moon MY, Kim MA. Development and evaluation of a web-based educational program on prevention of foot lesion in adults with diabetes. Journal of Korean Gerontological Nursing. 2010; 12(2):154–167.

24. Vileikyte L, Gonzalez JS, Leventhal H, Peyrot MF, Rubin RR, Garrow A, et al. Patient interpretation of neuropathy (PIN) questionnaire: An instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care. 2006; 29(12):2617–2624. https://doi.org/10.2337/dc06-1550.

25. Caputo GM, Cavanagh, PR, Ulbrecht JS, Gibbons GW, Kar-chmer AW. Assessment and management of foot disease in patients with diabetes. The New England Journal of Medicine. 1994; 331(13):854–860. https://doi.org/10.1056/NEJM199409293311307.

26. Jeong YH, Jeong IS, Kim MH. Study on the characteristics of foot diseases and foot care among diabetes mellitus patients. Korean Journal of Health Promotion. 2005; (4). 282–290.

27. Kim GH. Korean language education vocabulary by ratings. Seoul: ParkYiJung;2003. p. 386.

28. Ahmad Sharoni SK, Abdul Rahman H, Minhat HS, Shariff-Ghazali S, Azman Ong MH. The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility. Peninsular Malaysia. PLoS One. 2018; 13(3):e0192417. https://doi.org/10.1371/journal.pone.0192417.

29. Song MS, Gu MO, Ryu SA, Kim MS. Effect of a self-care program promoting self-efficacy for community elders with diabetes. Journal of Korean Gerontological Nursing. 2002; 4(1):22–37.

30. Beiranvand S, Fayazi S, Asadizaker M. Effect of educational program on the knowledge, attitude, and practice of foot care in patients with diabetes. Jundishapur Journal of Chronic Disease Care. 2015; 4(2):e26540. https://doi.org/10.5812/jjcdc.26540.