Effect of health education on foot care knowledge and practice of patients with type 2 diabetes in rural Bangladesh.

Abstract

BACKGROUND: Diabetic foot complications represent one of the most severe consequences of diabetes mellitus, with substantial global prevalence of diabetic foot ulcers. In Bangladesh, a significant proportion of type 2 diabetes patients are at risk of diabetic foot ulcers, yet patients’ foot care knowledge and practice remain largely unsatisfactory. This study aimed to explore the effectiveness of a foot care education session among rural diabetic patients in Bangladesh. METHODS: A single-group pre-post study design was employed to develop and apply a footcare education module among 51 patients with type 2 diabetes mellitus at Shailkupa Diabetic Hospital, Jhenaidah, Bangladesh, from August to December 2023. It included two sessions involving a slide presentation with video demonstrations, and hands-on practice with take-home booklets. Evaluation of the knowledge and practice score was done before and four weeks after the intervention. Knowledge was assessed using a validated 15-item questionnaire, while practice was evaluated using the 29-item Nottingham Assessment of Functional Foot Care (NAFF). RESULTS: Participants had a mean age of 52 (± 12) years (± SD), with 64.7% female and 76.5% experiencing diabetic foot-related problems. The educational intervention resulted in significant short-term improvements in both knowledge and practice scores (p < 0.001). Multiple linear regression analysis identified pre-intervention knowledge score (0.91 [β], 0.78 to 1.0 [95%CI]) as the most significant determinant of post-intervention knowledge score. The factors associated with post-intervention practice scores were pre-intervention practice scores (0.91, 0.74 to 1.1), and change in knowledge score (2.0, 0.95 to 3.0). CONCLUSION: Structured foot care education can be incorporated to improve diabetic foot care in routine diabetes management in resource-limited primary healthcare settings.