Effectiveness Diabetes Self-Management Education (DSME) to Foot Care Behaviour and Foot Condition in Diabetes Mellitus Patient
Diabetes mellitus (DM) is disease with hyperglycaemic condition. Hyperglycaemic can induce vascular problem (microvascular and macro vascular), neuropathy, and nephropathy. Microvascular and neuropathy can induce foot problem in patient, which can make amputation, increase medical cost, and care cost. Diabetes Self-Management and Education (DSME) can influence patient foot care behaviour and also patient foot condition. This research aim is to find effectiveness of DSME to patient foot care behaviour and patient foot condition. This research involve 112 respondents (intervention group= 56 respondents, control group= 56 respondents) with quasi experiment nonequivalent control group pre-test – post-test method. Intervention DSME was given for eight week with 15 minutes education every week for each patient, data collected by foot behaviour questionnaire and checking patient’s foot condition. In first week researcher collected pre-test data and in eight week researcher collect post-test data. Data analysed by ordinal regression at 5% for significant value. Result: DSME significantly increase foot care behaviour (p = 0.000) and influence foot behaviour 12.2%, DSME also significantly increase patient foot condition (p = 0.000) and influence foot condition 7.4%. DSME which applied with continuity can enhance foot care behaviour and awareness to checking foot condition then patient can avoid foot problem related to DM. Future research can use monofilament and Ankle Brachial Index for examination foot condition.
Keywords: DSME, foot care behaviour, foot condition
 A.Bus, S., Lavery, L., Monteiro-Soares, M., Rasmusen, A., Raspovic, A., Sacco, I., et al. (2019). IWGDF Guideline on the prevention of foot ulcers in persons with diabetes. Part of the 2019 IWGDF Guidelines on the Prevention and Management of Diabetic Foot Disease, pp. 1-35.
 Al-Wahbi, A. M. (2010). Impact of a Diabetic Foot Care Education Program on Lower Limb Amputation Rate. Vascular Health and Risk Management, 6, 923-934.
 American Diabetes Association. (2019). Standards of Medical Care in Diabetes-2019. Diabetes Care: The Journal of Clinical and Applied Research and Education, 1-193.
 Beiranvand, S., Fayazi, S., & Asadizaker, M. (2015). Effect of educational programs on the knowledge, attitude, and practice of foot care in patients with diabetes. Jundishapur Journal of Chronic Disease Care, 1-7.
 Bonner, T., Foster, M., & Spears-Lanoix, E. (2016). Type 2 Diabetes Related Foot Care knowledge and Foot Self-Care Practice Interventions in the United States: A Systematic Review of the Literature. Diabetec Foot & Ankle, 7(1), 1-7.
 Boulton, A. J., Armstrong, D. G., Albert, S. F., Frykberg, R. G., Hellman, R., Kirkman, M., et al. (2008). Comprehensive foot examination and risk assessment. Diabetes Care, 1679-1685.
 Darmawati, I. (2018). A Descriptive Study Of Woman Motivation For Partisipation In Exercise. In International Conference on Heath Care and Management 2018 (Vol. 1, No. 1).
 Fan, L., Sidani, S., Cooper-Brathwaite, A., & Metcalfe, K. (2014). Effects of a foot selfcare educational intervention on improving footwear choices in those with type 2 diabetes at low risk of foot ulceration. Diabetic Foot Canada, 2(2), 4-12.
 Formosa, C., Gatt, A., & Chockalingam, N. (2012). The importance of diabetes foot care education in a primary care setting. Journal of Diabetes Nursing, 16(10), 410-414.
 Gregg, E. W., Li, Y., Wang, J., Burrows, N. R., Ali, M. K., Rolka, D., et al. (2014). Changes in diabetes-related complications in the united states, 1990-201. The New England Journal of Medicine, 1514-1523.
 Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., et al. (2014). National standards for diabetes self-management education and support. Diabetes Care, 144-153.
 International Diabetes Federation. (2015). IDF Diabetes Atlas Seventh Edition 2015. New York: International Diabetes Federation.
 International Diabetes Federation. (2017). IDF Diabetes Atlas. Brussels, Belgium: International Diabetes Federation.
 Kemenkes. (2015). Petunjuk teknis pengelolaan kaki diabetes berbasis masyarakat. Jakarta: Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan Kementerian Kesehatan RI.
 Lavdaniti, M., & Dimitriadou, A. (2017). Foot Care Education for Diabetes Mellitus Patients. Journal of Nursing Science, 3(1), 1-4.
 Lewis, S., Bucher, L., Heitkemper, M. M., & Harding, M. (2017). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (10 ed., Vol. 2). St.Louis, Missouri: Elsevier.
 Li, R., Bilik, D., Brown, M. B., Zhang, P., Ettner, S. L., Ackermann, R. T., et al. (2013). Medical costs associated with type 2 diabetes complications and comorbidities. The American Journal of Managed Care, 19(5), 421-430.
 Mohamed, A. A.-R., El-Moneam, A. A.-G., & El-Sahky, N. M. (2018, Mar-Apr). Barrier of Foot Care Practice among Older Adults with Diabetes in Alexandria, Egypt. IOSR Journal of Nursing and Health Science (IOSSR-JNHS), 10-23.
 Neta, D. S., da Silva, A. V., & da Silva, G. R. (2015). Adherence to foot self-care in diabetes mellitus patients. Revista Brasileira de Enfermagem (REBEn), 68(1), 103-108.
 Ozawa, K., Tomisawa, T., Sakuraba, S., Urushizaka, M., Kitajima, M., Itaki, C., et al. (2014). Factors related to changes in foot status and foot care in patients with diabetes mellitus participating in an exercise health education program. Journal of Diabetes Mellitus, 4(1), 67-71.
 Powers, M. A., Barsdley, J., Cypress, M., Duker, P., Funnel, M. M., Fischl, A. H., et al. (2015). Diabetes self-management education and support in type 2 diabetes: A joint position statement of the american diabetes assocition, the american association of diabetes educators, and the academy of nutrition and dietetics. The Diabetes Educator, 1-14.
 Pretty, M. I., Gonzalez, M. C., & Hernandez-Diaz, A. (2018). Foot ulcers: perception of patients with Type 2 diabetes. Rev. Fac. Med, 66(2), 187-94.
 Sae-Sia, W., Maneewat, K., & Kurniawan, T. (2013, 05 04). Effect of a self-management support program on diabetic foot care behaviors. International Journal of Research in Nursing, 4(1), 14-21.
 Seid, A., & Tsige, Y. (2015). Knowledge, practice, and barriers of foot care among diabetic patients attending Fellege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Advance in nursing, 1-9.
 Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes selfcare activities measure. Diabetes Care, 943-950.