SAĞLIK İNANÇ MODELİ TEMELLİ WEB EĞİTİMİNİN TİP 2 DİYABETLİ BİREYLERDE DİYABETİK AYAK BAKIMI BİLGİSİ, DAVRANIŞLARI VE ÖZ-YETERLİLİK ÜZERİNDEKİ ETKİSİ
Öz
Amaç: Bu çalışmanın amacı, diyabetik ayak sorunu yaşama olasılığı düşük olan tip 2 diyabetli bireylerde Sağlık İnanç Modeli'ne dayalı web eğitiminin diyabetik ayak bakımı konusundaki bilgi, davranış ve öz yeterlilik üzerindeki etkisini değerlendirmektir.
Yöntem: Aralık 2021-Mayıs 2023 tarihleri arasında bir Aile Sağlığı Merkezi'nde randomize kontrollü çalışma olarak yürütülen bu araştırmaya, güç analizi sonucunda belirlenen 142 tip 2 diyabet hastası (deney grubu: 71, kontrol grubu: 71) dahil edildi. Deney grubu sağlık İnanç Modeline dayalı olarak iki haftada bir olmak üzere altı modül halinde web tabanlı eğitim aldı ve ardından 3 aylık bir takip gerçekleştirildi.
Bulgular: Deney ve kontrol gruplarının tanımlayıcı özellikleri (cinsiyet, yaş, eğitim vb.) ile hastalıkla ilişkili değişkenlerinin (diğer kronik hastalık varlığı, diyabet tedavi şekli vb.) homojen olduğu belirlendi (p>0.05). Hipotezler doğrultusunda yapılan analizlerde, deney grubunda eğitim sonrası diyabetik ayak bilgisi puanlarının (t=7.582; p=0.001), ayak bakımı davranış puanlarının (t=3.125; p=0.002) ve öz-yeterlilik puanlarının (t=4.337; p=0.001) kontrol grubuna göre anlamlı derecede arttığı görüldü. Grup içi karşılaştırmalarda deney grubunda bilgi düzeyi (t=-7.382; p=0.001), davranışlar (t=-2.100; p=0.039) ve öz-yeterlilik (t=-3.198; p=0.002) açısından pre-test ve post-test puanları arasında anlamlı farklar bulunurken kontrol grubunda bu değişim anlamlı değildi (p>0.05).
Sonuç: Bu çalışma, Sağlık İnanç Modeli’ne dayalı web eğitiminin, düşük riskli tip 2 diyabetli bireylerin ayak bakımı bilgisi, davranışları ve öz-yeterliliklerini artırmada etkili olduğunu göstermektedir. Hemşireler, dijital eğitim yöntemleriyle hastalarına erişilebilir eğitimler sunarak bakım davranışlarını iyileştirebilir ve hasta bakımını daha etkili yönetebilirler. Dijital eğitimler, hemşirelik pratiğinde etkili bir araç olabileceğini ve hastaların bakım davranışlarını iyileştirme potansiyelini ortaya koyarak literatüre önemli bir katkı sağlamaktadır.
Anahtar Kelimeler
Diyabetik ayak Diabetes mellitus Sağlık inanç modeli Öz yeterlilik Web temelli
Proje Numarası
TDK-2021-10219
Kaynakça
- Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. Eur J Prev Cardiol. 2019;26:7-14.
- IDF Diabetes atlas. 8th ed. International Diabetes Federation. Brussels, Belgium; 2017.
- Semerci Çakmak V, Çetinkaya Özdemir S. Patients with diabetic foot ulcers: a qualitative study of patient knowledge, experience, and encountered obstacles. J Tissue Viability. 2024;33(4):571-578.
- Everett E, Mathioudakis N. Update on management of diabetic foot ulcers. Ann N Y Acad Sci. 2018;1411:153-165.
- TEMD. Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu 2019. 13th edition. Ankara; 2019. (in Turkish).
- Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-2375.
- Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †. Ann Med. 2017;49(2):106-116.
- Mata‐Cases M, Roura‐Olmeda P, Berengué‐Iglesias M, et al. Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain. Int J Clin Pract. 2012;66:289-298.
- Lavery LA, Hunt NA, Ndip A, Lavery DC, Van Houtum W, Boulton AJM. Impact of chronic kidney disease on survival after amputation in ındividuals with diabetes. Diabetes Care. 2010;33:2365-2369.
- Bus SA, Lavery LA, Monteiro‐Soares M, et al. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36:1-18.
- Seyyedrasooli A, Parvan K, Valizadeh L, Rahmani A, Zare M, Izadi T. Self-efficacy in foot-care and effect of training: A single-blinded randomized controlled clinical trial. Int J Community Based Nurs Midwifery. 2015;3:141-149.
- Sharoni AS, Razi MM, Rashid AN, et al. Self-efficacy of foot care behaviour of elderly patients with diabetes Bachelor of Nursing (hons) (UiTM). Malaysian Fam Physician. 2017;12:2-8.
- Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient Empowerment: Results of a randomized controlled trial. Diabetes Care. 1995;18:943-949.
- Bohanny W, Wu S-FV, Liu C-Y, Yeh S-H, Tsay S-L, Wang T-J. Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. J Am Assoc Nurse Pract. 2013;25:495-502.
- Mahmoodi H, Abdi K, Navarro-Flores E, Karimi Z, Sharif Nia H, Gheshlagh RG. Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes. BMC Endocr Disord. 2021;21:72:1-7.
- Saleh NM, Shebl A, Hatata E, Refiei M. Impact of educational program about foot care on knowledge and self care practice for diabetic older adult patients. J Am Sci. 2012;8:1444-1452.
- Green EC, Murphy EM, Gryboski K. The Health Belief Model. Wiley Encycl Heal Psychol. 2020;2:211-214.
- Karimy M, Araban M, Zareban I, Taher M, Abedi A. Determinants of adherence to self-care behavior among women with type 2 diabetes: An explanation based on health belief model. Med J Islam Repub Iran. 2016;30:368:1-8.
- Sadeghi R, Baghernezhad Hesary F, Khanjani N. A Systematic Review about educational ınterventions based on the Health Belief Model (HBM) aimed to prevent and control diabetes in Iran. Int J Ayurvedic Med. 2020;11:15-22.
- Tavakoly Sany SB, Ferns GA, Jafari A. The effectiveness of an educational ıntervention based on theories and models on diabetes outcomes: A systematic review. Curr Diabetes Rev. 2020;16:859-868.
- Jafari M, Pasdar Y, Rezay M. Comparison of nutritional education using the blog, collaboration blog and SMS on blood glucose and lipid levels in type II diabetic patients. Med J Mashhad Univ Med Sci. 2013;56:5: 261-266.
- Shan R, Sarkar S, Martin SS. Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia. 2019;62:877-887.
- Elsabrout K. Increasing diabetic patient engagement and self-reported medication adherence using a web-based multimedia program. J Am Assoc Nurse Pract. 2018;30:293-298.
- Bakker K, Apelqvist J, Schaper NC. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes Metab Res Rev. 2012;28:225-231.
- Nguyen TPL, Edwards H, Do TND, Finlayson K. Effectiveness of a theory-based foot care education program (3STEPFUN) in improving foot self-care behaviours and foot risk factors for ulceration in people with type 2 diabetes. Diabetes Res Clin Pract. 2019;152:29-38.
- Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-2375.
- Zare S, Ostovarfar J, Kaveh MH, Vali M. Effectiveness of theory-based diabetes self-care training interventions; a systematic review. Diabetes Metab Syndr Clin Res Rev. 2020;14:423-433.
- Farahmand Z, Shojaeizadeh D, Tol A, Azam K. The ımpact of an educational program based on the health belief model on diabetic foot care in type-2 diabetic patients. J Sch Public Heal Inst Public Heal Res. 2017;15:171-184.
- Aalaa M, Sanjari M, Amini MR, et al. Diabetic foot care course: a quasi-experimental study on E-learning versus interactive workshop. J Diabetes Metab Disord. 2021;20:15-20.
- Gozum S, Capik C. Guide in the development of health behaviours: Health Belief Model (HBM). Dokuz Eylul Univ Fac Nurs Electron J. 2014;7:230-237.
- Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol. 2004;4:1-6.
- Colak B, Duran R, Can FN, et al. Measurement of diabetic patients’ knowledge about diabetic foot wound and evaluation of foot care practices. Turkish J Diabetes Obes. 2020;4:22-29.
- Şermet Kaya Ş, Kitiş Y. Elderly diabetes patients’ health beliefs about care and treatment for diabetes. J Hum Sci. 2018;15:51-61.
- Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The starr county diabetes education study. Diabetes Care. 2001;24:16-21.
- Kır Biçer E, Enç N. Validity and reliability of the Turkish form of the foot care behavior scale. Turkish Journal of Diabetes Nursing. 2014;6:35-9.
- Borges WJ, Ostwald SK. Improving improving foot self-care behaviors with Pies Sanos. West J Nurs Res. 2008;30:325-341.
- Quarles BE. Eduational methods increasing self-efficacy for the management of foot care in adults with diabetes and implementation of foot care behaviors. Dissertation, Doctor of Philosophy in The College of Education at The University of Kentucky, Lexington, Kentucky; 2005
- Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. 6th ed. Boston, MA: Pearson Education; 2013.
- Venkataraman K, Kannan AT, Kalra OP, et al. Diabetes self-efficacy strongly ınfluences actual control of diabetes in patients attending a tertiary hospital in India. J Community Health. 2012;37:653-662.
- Dincer B, Bahçecik N. The effect of a mobile application on the foot care of individuals with type 2 diabetes: A randomised controlled study. Health Educ J. 2021;80:425-437.
THE EFFECT OF HEALTH BELIEF MODEL BASED WEB EDUCATION ON DIABETIC FOOT CARE KNOWLEDGE, BEHAVIOURS AND SELF-EFFICACY IN INDIVIDUALS WITH TYPE 2 DIABETES
Öz
Objective: The aim of this study was to evaluate the effect of web training based on the Health Belief Model on knowledge, behavior and self-efficacy in diabetic foot care in individuals with type 2 diabetes who are at low risk of diabetic foot problems.
Method: The study, conducted as a randomized controlled trial at a Family Health Center between December 2021 and May 2023, included 142 individuals with type 2 diabetes (71 in the experimental group and 71 in the control group), as determined by power analysis. The experimental group received web-based training in six modules, one every two weeks, based on the Health Belief Model, followed by a 3-month follow-up.
Results: The descriptive characteristics (gender, age, education, etc.) and disease-related variables (presence of other chronic diseases, diabetes treatment type, etc.) of both experimental and control groups were found to be homogeneous (p>0.05). In the analyses conducted according to the hypotheses, post-intervention diabetic foot knowledge scores (t=7.582; p=0.001), foot care behavior scores (t=3.125; p=0.002), and self-efficacy scores (t=4.337; p=0.001) showed statistically significant increases in the experimental group compared to the control group. In within-group comparisons, significant differences were observed between pre-test and post-test scores in the experimental group regarding knowledge level (t=-7.382; p=0.001), behaviors (t=-2.100; p=0.039), and self-efficacy (t=-3.198; p=0.002), while no significant changes were detected in the control group (p>0.05).
Conclusion: This study shows that web education based on the Health Belief Model is effective in increasing foot care knowledge, behaviours and self-efficacy of individuals with low-risk type 2 diabetes. Nurses can improve care behaviours and manage patient care more effectively by providing accessible trainings to their patients through digital education methods. Digital trainings provide an important contribution to the literature by demonstrating that it can be an effective tool in nursing practice and its potential to improve patients' care behaviours.
Anahtar Kelimeler
Diabetes mellitus Diabetic foot Health belief model Self efficacy Web based
Destekleyen Kurum
Atatürk University Scientific Research Projects Coordination Unit
Proje Numarası
TDK-2021-10219
Kaynakça
- Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. Eur J Prev Cardiol. 2019;26:7-14.
- IDF Diabetes atlas. 8th ed. International Diabetes Federation. Brussels, Belgium; 2017.
- Semerci Çakmak V, Çetinkaya Özdemir S. Patients with diabetic foot ulcers: a qualitative study of patient knowledge, experience, and encountered obstacles. J Tissue Viability. 2024;33(4):571-578.
- Everett E, Mathioudakis N. Update on management of diabetic foot ulcers. Ann N Y Acad Sci. 2018;1411:153-165.
- TEMD. Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu 2019. 13th edition. Ankara; 2019. (in Turkish).
- Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-2375.
- Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis †. Ann Med. 2017;49(2):106-116.
- Mata‐Cases M, Roura‐Olmeda P, Berengué‐Iglesias M, et al. Fifteen years of continuous improvement of quality care of type 2 diabetes mellitus in primary care in Catalonia, Spain. Int J Clin Pract. 2012;66:289-298.
- Lavery LA, Hunt NA, Ndip A, Lavery DC, Van Houtum W, Boulton AJM. Impact of chronic kidney disease on survival after amputation in ındividuals with diabetes. Diabetes Care. 2010;33:2365-2369.
- Bus SA, Lavery LA, Monteiro‐Soares M, et al. Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36:1-18.
- Seyyedrasooli A, Parvan K, Valizadeh L, Rahmani A, Zare M, Izadi T. Self-efficacy in foot-care and effect of training: A single-blinded randomized controlled clinical trial. Int J Community Based Nurs Midwifery. 2015;3:141-149.
- Sharoni AS, Razi MM, Rashid AN, et al. Self-efficacy of foot care behaviour of elderly patients with diabetes Bachelor of Nursing (hons) (UiTM). Malaysian Fam Physician. 2017;12:2-8.
- Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient Empowerment: Results of a randomized controlled trial. Diabetes Care. 1995;18:943-949.
- Bohanny W, Wu S-FV, Liu C-Y, Yeh S-H, Tsay S-L, Wang T-J. Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. J Am Assoc Nurse Pract. 2013;25:495-502.
- Mahmoodi H, Abdi K, Navarro-Flores E, Karimi Z, Sharif Nia H, Gheshlagh RG. Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes. BMC Endocr Disord. 2021;21:72:1-7.
- Saleh NM, Shebl A, Hatata E, Refiei M. Impact of educational program about foot care on knowledge and self care practice for diabetic older adult patients. J Am Sci. 2012;8:1444-1452.
- Green EC, Murphy EM, Gryboski K. The Health Belief Model. Wiley Encycl Heal Psychol. 2020;2:211-214.
- Karimy M, Araban M, Zareban I, Taher M, Abedi A. Determinants of adherence to self-care behavior among women with type 2 diabetes: An explanation based on health belief model. Med J Islam Repub Iran. 2016;30:368:1-8.
- Sadeghi R, Baghernezhad Hesary F, Khanjani N. A Systematic Review about educational ınterventions based on the Health Belief Model (HBM) aimed to prevent and control diabetes in Iran. Int J Ayurvedic Med. 2020;11:15-22.
- Tavakoly Sany SB, Ferns GA, Jafari A. The effectiveness of an educational ıntervention based on theories and models on diabetes outcomes: A systematic review. Curr Diabetes Rev. 2020;16:859-868.
- Jafari M, Pasdar Y, Rezay M. Comparison of nutritional education using the blog, collaboration blog and SMS on blood glucose and lipid levels in type II diabetic patients. Med J Mashhad Univ Med Sci. 2013;56:5: 261-266.
- Shan R, Sarkar S, Martin SS. Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia. 2019;62:877-887.
- Elsabrout K. Increasing diabetic patient engagement and self-reported medication adherence using a web-based multimedia program. J Am Assoc Nurse Pract. 2018;30:293-298.
- Bakker K, Apelqvist J, Schaper NC. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes Metab Res Rev. 2012;28:225-231.
- Nguyen TPL, Edwards H, Do TND, Finlayson K. Effectiveness of a theory-based foot care education program (3STEPFUN) in improving foot self-care behaviours and foot risk factors for ulceration in people with type 2 diabetes. Diabetes Res Clin Pract. 2019;152:29-38.
- Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-2375.
- Zare S, Ostovarfar J, Kaveh MH, Vali M. Effectiveness of theory-based diabetes self-care training interventions; a systematic review. Diabetes Metab Syndr Clin Res Rev. 2020;14:423-433.
- Farahmand Z, Shojaeizadeh D, Tol A, Azam K. The ımpact of an educational program based on the health belief model on diabetic foot care in type-2 diabetic patients. J Sch Public Heal Inst Public Heal Res. 2017;15:171-184.
- Aalaa M, Sanjari M, Amini MR, et al. Diabetic foot care course: a quasi-experimental study on E-learning versus interactive workshop. J Diabetes Metab Disord. 2021;20:15-20.
- Gozum S, Capik C. Guide in the development of health behaviours: Health Belief Model (HBM). Dokuz Eylul Univ Fac Nurs Electron J. 2014;7:230-237.
- Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol. 2004;4:1-6.
- Colak B, Duran R, Can FN, et al. Measurement of diabetic patients’ knowledge about diabetic foot wound and evaluation of foot care practices. Turkish J Diabetes Obes. 2020;4:22-29.
- Şermet Kaya Ş, Kitiş Y. Elderly diabetes patients’ health beliefs about care and treatment for diabetes. J Hum Sci. 2018;15:51-61.
- Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The starr county diabetes education study. Diabetes Care. 2001;24:16-21.
- Kır Biçer E, Enç N. Validity and reliability of the Turkish form of the foot care behavior scale. Turkish Journal of Diabetes Nursing. 2014;6:35-9.
- Borges WJ, Ostwald SK. Improving improving foot self-care behaviors with Pies Sanos. West J Nurs Res. 2008;30:325-341.
- Quarles BE. Eduational methods increasing self-efficacy for the management of foot care in adults with diabetes and implementation of foot care behaviors. Dissertation, Doctor of Philosophy in The College of Education at The University of Kentucky, Lexington, Kentucky; 2005
- Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. 6th ed. Boston, MA: Pearson Education; 2013.
- Venkataraman K, Kannan AT, Kalra OP, et al. Diabetes self-efficacy strongly ınfluences actual control of diabetes in patients attending a tertiary hospital in India. J Community Health. 2012;37:653-662.
- Dincer B, Bahçecik N. The effect of a mobile application on the foot care of individuals with type 2 diabetes: A randomised controlled study. Health Educ J. 2021;80:425-437.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Halk Sağlığı Hemşireliği |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | TDK-2021-10219 |
| Yayımlanma Tarihi | 28 Nisan 2025 |
| Gönderilme Tarihi | 9 Eylül 2024 |
| Kabul Tarihi | 21 Aralık 2024 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 6 Sayı: 1 |
Bu eser Creative Commons Atıf-GayriTicari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.