Application of Transtheoretical Model of Change on Foot Care Management among Diabetic Patients: Prevention Better than Cure

Abstract

Diabetic foot ulcer is one of the most common consequences of uncontrolled blood glucose level which takes place in 15% of people with diabetes, and precedes 84% of all diabetes-related lower-leg amputations that have the adverse effect on the diabetic patients causing physical, psychosocial, and financial burden as well as an economic burden on health care system. The aim of the study is to improve foot care management among diabetic patients by applying the Transtheoretical Model of Change. Design: A quasi-experimental design was conducted with a systematic random sample. Study sample: 154 patients who were selected from the registration system were divided equally into (77 study group) and (77 control group). Setting: the study was conducted at the outpatient diabetic clinic affiliated to Tanta University Hospital and Segar primary health care center affiliated to ministry of health, Tanat Governorate, Egypt. Tools: three tools were used for the purpose of data collection (I) Bio-socio-demographic characteristics questionnaire;(II)Trans-theoretical Model scale and (III) Diabetes Management Self-Efficacy Scale (DMSES). A survey was conducted by using Arabic version of self-reporting questionnaire to assess the stages of change and self efficacy among the studied groups as a baseline and during the implementation of foot care intervention program. Results revealed that, there was a statistical significant difference in the stages of change of the Transtheoretical Model for diabetic foot care management of the study group compared to the control group at 2, 4, and 6 months after implementation of intervention program. In addition, there was a statistical significant difference in Diabetes Management Self-Efficacy Levels between study group who received program intervention compared to control group 6 months after intervention. Recommendation: encouraging nurses who are dealing with diabetic patients to use the Transtheoretical Model of change or other health promotion models to enhance diabetic patient for foot care management, and adoption of healthy behavior.

Keywords: Transtheoretical model of change, diabetic foot care management.