Diabetic foot self care

NewsBot · Jul 19, 2025

Diabetic Foot Care Education and Practices: A Knowledge, Attitudes, and Practices Questionnaire-Based Study
Aishwarya Singh et al
Cureus. 2025 Jun 5;17(6):e85436.

Background Diabetic foot disease is a significant cause of morbidity among individuals with diabetes and can be effectively prevented with proper patient education early in the disease course. This study was conducted with the aim of assessing the knowledge, attitudes, and practices of diabetic patients toward foot care, as well as estimating the prevalence of diabetic foot disease. Methods A cross-sectional study was conducted among 128 diagnosed patients with diabetes, using a structured questionnaire and the Michigan Neuropathy Screening Instrument (MNSI) parts A and B, at a referral hospital in Central India. The questionnaire included questions about foot care practices, knowledge of diabetic foot complications, and attitudes toward foot care. The MNSI was used to screen for neuropathic symptoms and signs indicative of diabetic foot disease. Results Among the participants, 110 out of 128 (85.9%) reported that they had never received any education from their healthcare provider regarding proper foot care practices. Almost one-fourth of our participants, accounting for 95 (74.2%) of them, lacked adequate knowledge about maintaining proper foot hygiene, and 78 (60.9%) were unaware of the foot-related complications associated with diabetes. The study found a significant positive association between knowledge scores and the duration of diabetes. Despite the lack of knowledge, 125 (97%) of the patients demonstrated a positive attitude and expressed a willingness to adopt proper practices when educated. Notably, 52 (40.6%) of the participants walked barefoot, and 116 (90.6%) did not undergo annual foot examinations. Diabetic foot disease was identified in 40 out of 128 (31.3%) participants based on abnormal MNSI scores. There was a significant positive correlation between the duration of diabetes and the presence of diabetic foot disease. Higher MNSI score A was associated with poorly controlled diabetes, highlighting the impact of glycemic control on neuropathic symptoms. The presence of diabetic foot disease was also significantly associated with macroalbuminuria. Conclusion Our study revealed substantial deficiencies in the education of diabetic patients concerning foot care practices. The prevalent positive attitude among the patients indicates that diabetic foot disease can be effectively prevented with adequate patient education and proactive care by primary healthcare providers. Addressing these deficiencies in awareness and practice is essential for improving patient outcomes and preventing severe complications associated with diabetic foot disease.
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NewsBot · Jul 27, 2025

Diabetic foot self-care practices and its predictors among diabetes mellitus patients in Ethiopia: systematic review and meta-analysis
Sefineh Fenta Feleke et al
BMJ Open. 2025 Mar 13;15(3):e092626. doi: 10.1136/bmjopen-2024-092626

Objective
The study aims to identify self-care practices related to diabetic foot care and determine their predictors among diabetes mellitus (DM) patients in Ethiopia.

Design
Systematic review and meta-analysis.

Data sources
Data were collected from PubMed/MEDLINE, ScienceDirect, Google Scholar and grey literature sources. Databases were searched from inception to August 2024.

Eligibility criteria
Observational studies (including cross-sectional, case–control, cohort and survey designs) reporting diabetic foot self-care practices and their predictors among DM patients in Ethiopia. Our inclusion criteria encompassed articles published in English, and we considered studies conducted in both healthcare institutions and community settings.

Data extraction and synthesis
Microsoft Excel was used for data extraction and summary, while the analysis was performed with R software V.4.3.2. The overall pooled prevalence of diabetic foot self-care practices and their predictors were estimated using a random-effects model. Publication bias was assessed both graphically, using funnel plots, and statistically, with tests such as Egger’s regression test. The reviewers systematically assessed potential bias in individual studies using the Newcastle–Ottawa Quality Assessment Scale, and the certainty of evidence was assessed by Grade of Recommendations Assessment, Development and Evaluation (GRADE). Subgroup analysis was carried out to minimise random variations in the estimates from the primary studies.

Results
The pooled prevalence of good diabetic foot self-care practice in Ethiopia was 51% (95% CI: 41% to 61%; I²=98%, p≤0.001). Factors associated with diabetic foot self-care practices among diabetic patients included knowledge of foot care (adjusted OR (AOR)=2.42; 95% CI: 1.20, 3.62), being female (AOR=1.23; 95% CI: 1.02, 1.98) and rural residency (AOR=1.23; 95% CI: 1.02, 1.98). Both Egger’s test (p=0.4430) and Begg’s test (p=0.501) indicated no significant evidence of publication bias. Regarding the certainty of evidence, the overall GRADE rating is categorised as low.

Conclusions
The overall prevalence of good diabetic foot self-care practices among DM patients in Ethiopia is relatively high. Residence, sex and knowledge of foot care were identified as key predictors of effective foot self-care practices in this population. To enhance diabetic foot self-care in Ethiopia, it is crucial to strengthen education on foot care. Tailored interventions should be developed specifically for men and rural residents to improve their diabetic foot self-care practices.
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NewsBot · Aug 3, 2025

Knowledge, attitudes, and practices among patients with diabetic foot ulcers towards disease management
Liangxiao Xie et al
Sci Rep. 2025 Aug 1;15(1):28152.

This study aimed to assess the knowledge, attitudes and practices (KAP) among patients with diabetic foot ulcers toward disease management. This web-based cross-sectional study was conducted between April and December 2023 at the Zhangzhou Affiliated Hospital of Fujian Medical University. Patients diagnosed with diabetic foot ulcers were invited to participate. A structured self-administered questionnaire was used to collect data on demographic characteristics, KAP related to diabetic foot ulcer management. A total of 508 valid responses were analyzed. Pearson's correlation analysis and path analysis were performed to explore the relationships among knowledge, attitudes, and practices. A self-designed questionnaire was designed to gather demographic information from patients with diabetic foot ulcers and to assess their KAP toward disease management. A total of 508 valid questionnaires were collected. Among the participants, 273 (53.74%) were male, 345 (67.91%) were elder than 60 years old, 393 (77.36%) resided in rural area and 470 (92.52%) reported not engaging in regular exercise. The mean knowledge, attitudes, and practices scores were 6.15 ± 1.54 (possible range: 0-11), 35.49 ± 2.87 (possible range:12-60), and 26.81 ± 2.60 (possible range: 10-50), respectively. The path analysis demonstrated that knowledge exerted a direct influence on attitudes (β = 0.751, P < 0.001) and practices (β = 0.380, P < 0.001), with an additional indirect effect on practices through attitudes (β = 0.332, P < 0.001). Furthermore, attitude demonstrated a direct impact on practices, as indicated by a path coefficient of 0.442 (P < 0.001). Patients with diabetic foot ulcers showed good knowledge and positive attitudes, yet specific deficiencies remain, highlighting the need for ongoing patient education and healthcare support.
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NewsBot · Sep 12, 2025

Why Do Diabetic Patients Not Take Care of Their Feet? Knowledge, Attitude, and Preventive Practices for Diabetic Foot: A Cross-Sectional Study at a Tertiary Care Center in India
Aditya Amit Godbole, Mrunal N. Ketkar, Seema Bunglowala, Disha Hegde, Ananya Arora, Garvita Singh & Niska Malani
Indian Journal of Surgery

Diabetic foot ulcers (DFUs) are serious yet preventable complications of diabetes mellitus (DM). They cause significant morbidity, lead to amputations, and impose financial burdens on the healthcare system. While proper preventive care can reduce the risk of DFUs, patients in developing countries often have inadequate awareness. This study focuses on the knowledge, attitudes toward foot care, and foot care practices among DM patients in India. A total of 500 patients with DM were interviewed in December 2024 using a structured tool assessing their medical history, knowledge, attitude, and foot care practices. Data was analyzed using SPSS (29.0). Knowledge was categorized as poor, average, or good, while attitude was classified as negative or positive. Their association with past histories and demographics was examined using Pearson’s chi-square test. Almost half of the participants had poor knowledge (49.4%), with educational levels significantly influencing awareness. A positive attitude toward foot care was observed in 82.4% of participants. However, this attitude did not translate into practice: 61.2% of respondents had never undergone a foot check-up, 52% relied on self-medication and care, and only 10.4% used diabetic footwear. A major gap exists between the desired level of preventive measures and current practices among DM patients. Targeted education, pre-emptive counseling, and proactive physician involvement are essential to bridge the gap and reduce the burden of DFUs.
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NewsBot · Sep 25, 2025

Optimizing Self-Management for People Living With Chronic Diabetic Foot Ulcers: A Longitudinal Qualitative Study
Shupeng Shi et al
J Wound Ostomy Continence Nurs. 2025 Sep-Oct;52(5):376-383.

Purpose: The aim of this study was to identify facilitators and barriers in dynamic self-management in order to optimize individualized strategies of persons with diabetic foot ulcers (DFUs).

Design: Longitudinal qualitative research design.

Participants and setting: The sample comprised 18 participants diagnosed with a DFU and 10 family caregivers; respondents were recruited from Sun Yat-sen Memorial Hospital, a metropolitan tertiary center with a diabetic foot multidisciplinary care team located in Guangzhou, China.

Methods: Semi-structured interviews were constructed guided by self- and family-management (SFM) framework. Interviews occurred around 1, 3, and 6 months after DFU diagnosis. Data were analyzed using thematic analysis. Data collection was conducted between September 2023 and June 2024.

Results: Eleven subthemes were identified as either facilitators or barriers and were categorized according to the 3 stages of DFU-SFM. They were (1) SFM buildup: motivation and determination, support network at its peak, information overload and uncertainty; (2) SFM adaption: activating more resources, establishing a virtuous cycle, waning support network and accumulation of negative experiences; and (3) SFM optimization: test the boundaries, reflection and personalization and living with DFU.

Conclusions: We identified strategies to optimize DFU self-management that occurred in in stages. We hypothesize that providing earlier structured education that incorporates skills start SFM, a holistic approach that goes beyond wound care to maintain SFM, and enhancing self-monitoring and external supervision to optimize SFM.
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NewsBot · Oct 1, 2025

Effectiveness of pictorial educational intervention on foot care among individuals having type 2 diabetes at slums of Karachi, Pakistan: asingle blinded randomized control trial
Hina Sharif et al
BMC Public Health. 2025 Sep 30;25(1):3214.

Background: Diabetes elevates the chance of severe health complications, such as Diabetic Foot (DF), which detrimentally affects quality of life. A significant proportion of diabetes mellitus patients, particularly in the slums of Karachi, lack awareness of foot care, hence increasing their risk of foot ulcers and amputations. This exacerbates the healthcare cost owing to avoidable complications of diabetes.

Aim: The primary objective of this study was to evaluate the effectiveness of a pictorial infographic-based foot care education intervention among patients with diabetes in the slums of Karachi, Pakistan. By assessing the impact of this intervention, we aimed to provide valuable insights into the design of future diabetes care and education programs.

Methodology: A single-blinded randomized control trial was conducted at one clinic of the primary healthcare organization SINA, providing primary healthcare services in slums. Using repeated measures of ANOVA to evaluate the effect of group (intervention vs. control), time (pre-and post), and their interaction on scores and pair t-test to check the mean difference of scores in intervention and control group at baseline and after 3 months. The data were cleaned and analyzed in STATA 17.

Results: Of 180 individuals, 90 were in each arm-intervention and control. In the intervention arm, 83 completed follow-up and 77 in the control. In the control and interventional groups, 77.9% and 80.7% of 160 participants were female. Participants' mean age, BMI, and diagnosis years were 54.92 ± 10.41 years, 28.99 ± 6.22, and 7.99 ± 6, respectively. The repeated measures ANOVA showed significant main effects for both groups (F (1, 158) = 45.65, p < 0.0001) and time (F(1, 158) = 172.30, p < 0.0001), showing significant changes in scores. A substantial interaction effect between group and time indicates that ratings changed differently over time for the two groups. The intervention affected the groups differently, with considerable variations over time. Additionally, after education intervention, the intervention arm showed a significant improvement in mean difference (mean difference: 3.53, 95% CI 3.11-3.96, p < 0.001) compared to the control group (mean difference: 0.87, 95% CI 0.34-1.40, p < 0.001) from baseline.

Conclusion: Education had a crucial role in positively impacting patient behavior. Therefore, patients must be actively involved in their healthcare education awareness, focusing more on modifying their behavior.
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NewsBot · Oct 25, 2025

Instruments for measuring diabetic foot self-care behavior: a systematic review of measurement properties
Deborah Siregar et al
Diabetes Res Clin Pract. 2025 Oct 22:112946.

Aims: To synthesize and critically evaluate the psychometric properties of patient-reported outcome measures (PROMs) designed to assess diabetic foot self-care behaviors.

Methods: A systematic search was conducted in PubMed, EMBASE, CINAHL, and Cochrane databases up to February 2024. Eligible studies included adults (≥18 years) with diabetes who could independently perform daily foot care, and only instruments assessing self-reported foot care practices were included. Studies were excluded if diabetes was not the primary condition, instruments were unrelated, or full-text data were unavailable. The methodological quality and measurement properties of these instruments were assessed using the COSMIN checklist and a modified GRADE approach.

Results: Seven self-report instruments for assessing diabetic foot self-care were identified across 16 studies. The review found considerable variability in the methodological quality and psychometric robustness of the included PROMs. The Diabetic Foot Self-Care Questionnaire (DFSQ) consistently showed adequate content validity, structural validity, and internal consistency, and was validated across several cultural context.

Conclusion: Despite generally adequate psychometric properties, the evidence is limited by small and variable sample sizes, lack of longitudinal data, incomplete cross-cultural representation, and potential publication bias. Overall, the DFSQ demonstrated the most robust psychometric properties and recommended as a reliable and valid tool for assessing diabetic foot self-care behaviors in both research and clinical practice.
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NewsBot · Oct 29, 2025

Foot Care Interventions for Low-risk Diabetic Patients and those Without Foot Ulcers: A Mapping Review
Okatiranti Okatiranti, Desy Nuryunarsih
Source

Patient education on appropriate self-care has the potential to play a crucial role in preventing foot complications. No current reviews explored the evidence of foot care interventions (FCIs) for diabetic patients who are at low risk for diabetic foot ulcers (LR-DFUs). This mapping review aimed to identify existing evidence of the core components of FCI for diabetic patients who are LR-DFUs and without DFUs. Methods: This review was undertaken using the Joanne Briggs Institute (JBI) guidance. The following electronic databases were searched for articles from data first indicated date through to June 2021: CINAHL, EMBASE, Medline, PubMed, Cochrane Library, Scopus, Science Direct, and ASSIA. APA PsycArticles, ProQuest Dissertations and Theses, and institutional websites by using search terms related to foot care and diabetes mellitus. A narrative synthesis was used to summarize the data. Results: In total, 18 studies were included in this review. Of these, there were 12 comparative studies, six observational studies and 12 reports of footcare education. The review included studies representing low- and high-resource settings and presented the core components of FCI for patients who are LR-DFUs and without DFUs. Conclusion: Core components of FCIs can be applied to develop targeted FCIs for education.
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NewsBot · Nov 8, 2025

Impact of the Interprofessional Collaborative Education Program (IPCEP) on the knowledge, attitudes, and practices of diabetic foot care among individuals with type 2 diabetes mellitus: a narrative review
Bhukya Nom Kumar Naik, Sushma Prabhath, Elsa Sanatombi Devi, Arun G. Maiya, S. S. Prasad, Suvarna Hebbar, Gagana Karkada, Sahana Shetty & Shubhada Karanth
Source

Background

Individuals with diabetes are at high risk of foot complications such as ulcers and amputations, leading to morbidity and economic burden. Effective foot care management reduces complications, highlighting the need for patient education and self-management practices. Interprofessional care (IPC) enhances patient care by integrating expertise from multiple disciplines. While education programs improve self-care and knowledge, their impact on self-efficacy remains unclear. Furthermore, the role of the Interprofessional Collaborative Education Program (IPCEP) in enhancing foot care practices also needs exploration.
Objective

This narrative review evaluated the usefulness of the interprofessional approach (IPA) to patient-centered education in improving foot care knowledge, attitudes, and practices (KAPs) among individuals with type 2 diabetes mellitus (T2DM).
Methods

A systematic search of PubMed, Scopus, and Cochrane was carried out to explore the importance of IPCEP in improving foot care practices among individuals with T2DM. A narrative review was conducted, as there was a paucity of literature related to studies meeting the criteria by September 23, 2024. Studies assessing patient outcomes (behaviour, attitudes, knowledge) were considered.
Results

Extensive research is needed to highlight the importance of IPCEP in improving foot care knowledge and promoting proactive self-management. This is because the IPA positively influences patients’ attitudes toward health management post-education.
Conclusion

This review highlights the need for IPCEP to improve foot care practices; thus, it can foster a holistic approach to diabetes and diabetic foot care, improve quality of life, and reduce complications.
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NewsBot · Dec 1, 2025

KNOWLEDGE AND PRACTICE OF FOOTCARE AMONG PATIENTS WITH DIABETIC FOOT ULCER
ASWATHY K A A.K.A., SINGH DR.A.
INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND APPLICATIONS

Objective: To assess the knowledge and practice of foot care among patients with Diabetic foot ulcer patients. Methodology: The study was conducted among 130 consecutive patients from the Department of Surgery, Government Medical college, Thiruvananthapuram and they were diagnosed with Diabetic foot ulcer and those who are willing were included in the study and those with cognitive impairment were excluded from the study. Study Procedure:A written informed consent will be taken from the patient or caregiver in a prescribed format. Patient who met the inclusion criteria will be enrolled for the study. All information relevant to the study was collected from case records and direct interview with patient with the help of questionnaires.. Knowledge and practice of foot care was assessed using questionnaire based on recommendation by American Diabetics Association.

Conclusion:. Wound duration was identified as the only risk factor for MRSA infection in DFU.. Appropriate implementation of foot care strategies reduce the risk of amputation by 49%-85%.To achieve this effect, we must emphasize on awareness of foot care
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NewsBot · Dec 31, 2025

The effectiveness of self-efficacy enhancement for foot care program on HbA1c and foot status in people with type 2 diabetes in Thailand: A quasi-experimental study
Sangthong Terathongkum et al
Belitung Nurs J. 2025 Nov 26;11(6):794-801.

Background: Diabetic foot ulceration (DFU) is a common and serious complication in people with type 2 diabetes mellitus (T2DM), leading to morbidity, lower-extremity amputation, and reduced quality of life. Effective interventions focusing on glycemic control, foot care, and exercise are essential to prevent DFU.

Objective: This study aimed to evaluate the effectiveness of the 12-week Self-Efficacy Enhancement for Foot Care Program (SEFP) on HbA1c levels and foot status, including peripheral sensory loss and skin and peripheral vascular abnormalities, in people with T2DM in Thailand.

Methods: A quasi-experimental study with a two-group pretest-posttest design was conducted between October 2019 and January 2020 with 80 participants (40 per group) recruited from two public health centers in Bangkok. The experimental group received SEFP plus usual nursing care, while the control group received only usual nursing care. The SEFP included diabetes education, behavior modification, foot care, and 10-chair-pose foot exercises, with home visits, telephone follow-ups, and group discussions. Data collection included demographic questionnaires, HbA1c measurements, and foot status assessments using the Semmes-Weinstein Monofilament and clinical examination of skin and vascular abnormalities. Paired t-tests, independent t-tests, and ANCOVA were used to analyze within- and between-group differences.

Results: Baseline characteristics were comparable between groups. After the intervention, the experimental group showed significant reductions in HbA1c (t = 5.24, p <0.001) and significant improvements in overall foot status (t = -8.75, p <0.001), peripheral sensory loss (t = -2.97, p = 0.005), and skin and peripheral vascular abnormalities (t = -10.32, p <0.001). ANCOVA revealed significant between-group differences in post-intervention HbA1c (F = 30.56, p <0.001) and foot status measures (overall: F = 61.61, p <0.001; peripheral sensory loss: F = 11.76, p <0.001; skin and vascular abnormalities: F = 56.79, p <0.001).

Conclusion: The 12-week SEFP was associated with reductions in HbA1c and improvements in foot status in people with T2DM. This program is potentially recommended for nurses in primary healthcare settings to prevent DFU and enhance clinical outcomes. Long-term studies with objective vascular measures are warranted to confirm sustained effects.
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NewsBot · Jan 29, 2026

The effects of culturally tailored diabetic foot education sessions on the adult immigrant outpatients
NameYeasmin, Samira et al
Source

DescriptionPurpose of Project

The purpose of this project was to implement culturally tailored diabetic foot care education to enhance awareness and reduce foot health complications among immigrant diabetes patients in the suburban outpatient clinic.

Methods

A quantitative pre- and post-test design was utilized consisting of 15 immigrant patients with diabetes. Culturally tailored foot care education was provided using American Diabetes Association (ADA) foot care checklists, delivered verbally in participants' primary languages (Bangla, Spanish, and Arabic). Outcomes were measured using the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) and Diabetic Foot Self-Behavior Scale (DFSBS). Data analysis included paired t-tests and chi-square tests using SPSS software.

Results

There was a statistically significant improvement in participants' diabetic foot care knowledge (p < .001) and self-care practices (p < .001). Additionally, there was a significant correlation between podiatry visits and improved foot health (p = .038).

Implications for Practice

Culturally tailored foot care education significantly improves knowledge and preventive foot care behaviors among immigrant populations. Healthcare facilities should integrate education programs regularly to enhance patient outcomes and reduce diabetes-related foot complications.
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NewsBot · Mar 6, 2026

Analysis on the current status of foot self - management and influencing factors of high - risk diabetic foot patients based on COM-B model
Lanlan Xia et al
J Tissue Viability. 2026 Feb 16;35(2):100988.

Objectives: Investigate the current status of foot self-management in high-risk diabetic foot patients, and explore the influencing factors of foot self-management behavior based on the COM-B model.

Methods: A total of 394 high-risk diabetic foot patients who met the inclusion and exclusion criteria in the inpatient department of endocrinology at a tertiary hospital in Shanghai were selected as the research subjects using the convenience sampling method. The survey was conducted using a general information questionnaire, the Chinese version of the Nottingham foot care Assessment Scale, the Diabetes Health Literacy Scale, the Diabetic Foot Self-efficacy Scale, and the Chronic Illness Resource Utilization Survey Scale.

Results: The average score of foot self-management behavior among high-risk diabetic foot patients was 39.29 ± 13.07. Multiple linear regression analysis identified influencing factors including age, education level, smoking status, history of diabetes health education, diabetes health literacy, foot self-efficacy, and chronic disease resource utilization. Structural equation modeling analysis revealed that diabetes health literacy and utilization of chronic illness resources not only have a direct positive impact on foot self-management behavior in high-risk diabetic foot patients but also exert an indirect positive influence through foot self-efficacy.

Conclusion: The foot self-management ability of high-risk diabetic foot patients is at a medium level and needs to be improved. In the future, the Foot Self-management Ability of high-risk diabetic foot patients can be improved by enhancing their health literacy and utilization of chronic disease resources.
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NewsBot · Mar 27, 2026

Development of a Patient-Centered Daily Foot Self-Care Protocol for High-Risk Diabetic Foot Patients Based on Checklist Management Model: A Delphi Study
Xiaodan Lin et al
Diabetes Metab Syndr Obes 2026 Feb 3:19:545241.

Background: The International Diabetic Foot Working Group emphasizes that daily foot self-care is a critical measure for preventing diabetic foot ulcers, with patients serving as the primary implementers. However, there is a notable lack of patient-centered, specific, and actionable care management plans. This study aims to develop a scientifically sound, standardized, and practical daily foot self-care protocol for high-risk diabetic foot patients based on the checklist management model.

Methods: This study was conducted in two sequential phases. First,a preliminary draft of the foot self-care program was developed through a comprehensive literature review and semi-structured interviews with healthcare professionals and patients. Subsequently, from December 2024 to January 2025, the Delphi method was employed to conduct two rounds of expert consultation with 17 specialists, during which the indicators were screened and refined based on predefined criteria.

Results: In the first and second rounds of expert consultations, 18 and 17 questionnaires were distributed, respectively, with 17 valid responses returned each round, yielding effective response rates of 94.44% and 100%. The expert authority coefficient was 0.93, indicating high credibility. The Kendall's harmony coefficients were 0.168 and 0.272 (p<0.001), reflecting improved consensus across rounds. In the second round, the coefficient of variation ranged from 0 to 0.16, with all items below the 0.25 threshold. The final self-care plan comprises 5 primary indicators (self-foot examination, foot hygiene care, shoe and sock selection, daily precautions, and daily foot self-care flowchart) and 27 secondary indicators.

Conclusion: The self-care plan developed using the checklist management model is scientifically grounded, targeted, and feasible. It provides a structured basis for effective and standardized self-care among high-risk diabetic foot patients, However, it is essential to note that this protocol is still in the developmental stage and requires further clinical validation to assess its practical effectiveness and implementation feasibility.
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NewsBot · Apr 5, 2026

Evaluation of the Present Perspective on Diabetic Foot Syndrome and Health Education and Analysis of the Impact of Educational Interventions: A Systematic Review and Meta-Analysis
Sol Tejeda-Ramírez e t al
Source

Aims: To evaluate the effectiveness of preventive educational interventions in individuals with diabetic foot syndrome (DFS) and to summarise current evidence on knowledge, self-care and health-education strategies related to this complication. Materials and methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Risk of bias was evaluated using the Cochrane Handbook recommendations. Analyses were performed with Review Manager v5.4.1. Results: Educational interventions produced a significant improvement in patient knowledge and self-care practices compared with usual care. Despite some heterogeneity across studies, the overall effect favoured structured education as a preventive strategy for DFS-related complications. Conclusions: Preventive educational interventions enhance knowledge and self-care among individuals with DFS. Implementing structured education programs may help reduce complications and improve clinical outcomes.
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NewsBot · May 20, 2026

Barriers to Self-Management of Patients with Diabetic Foot Ulcers: A Systematic Review and Qualitative Meta-Synthesis
Qin Liu et al
Advances in Skin & Wound Care Publish Ahead of Print, May 18, 2026. | DOI: 10.1097/ASW.0000000000000469

OBJECTIVE:

To synthesize qualitative research on self-management among patients with diabetic foot ulcers (DFUs) to provide insights and recommendations for enhancing self-management interventions.
DATA SOURCES:

A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, WanFang, and VIP databases was conducted through August 15, 2024.
STUDY SELECTION:

Studies were selected based on the PICo-D model; P (Population) was patients with DFUs, I (Interest) was barriers to self-management, Co (Context) was the patient’s life following a DFU diagnosis, and D (Design) was qualitative or mixed-method studies. Exclusion criteria included duplicate publications, unavailable full text, and literature published in languages other than Chinese or English.
DATA EXTRACTION:

Two researchers independently screened, assessed quality, and extracted data. Discrepancies were resolved by discussion or a third reviewer. Extracted data included authors, year, country, methodology, sample size, phenomenon of interest, and key findings.
DATA SYNTHESIS:

A meta-synthesis approach integrated findings from 14 studies with 256 participants. Barriers to DFU self-management were grouped into eight themes: (a) cognitive factors (eg, lack of knowledge, information processing, decision-making abilities, self-efficacy); (b) emotional factors; (c) behavioral factors (eg, behavioral habits, adherence); (d) social factors (eg, social resources, social support); (e) economic factors; (f) environmental factors (eg, living environment, environmental support); (g) policy factors (eg, policy support, resource allocation, regulatory restrictions); and (h) cultural factors (eg, cultural identity, traditional beliefs).
CONCLUSIONS:

Patients with DFUs face multiple barriers to effective self-management. Health care providers should focus on enhancing health education, providing psychological support, fostering a supportive environment, and implementing personalized interventions to improve patients’ self-management abilities and strengthen their overall prognosis.
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NewsBot · Jun 10, 2026

Assessing an asynchronous 6-week video-based storytelling program to empower diabetic foot care: A patient-centered pilot study
Hsiao-Hui Ju et al
J Am Assoc Nurse Pract. 2026 May 26.

Background: People with diabetes with an A1C level above 8% are at greater risk of developing serious diabetic foot disease.

Purpose: To create and pilot an asynchronous educational storytelling video program as a mechanism to engage individuals at risk for developing diabetic foot disease to improve foot care knowledge and practices.

Methods: A multidisciplinary team developed six engaging storytelling videos on diabetes foot care. Knowledge of foot care was assessed before and after each video, and foot care behaviors were measured using the Summary of Diabetes Self-Care Activities (SDSCA) foot scale at baseline, 6-week, and 12-week follow-up.

Results: A high level of engagement was observed with an 80% (24/30) program completion rate and a 73% (22/30) study retention rate. There were significant improvements in their foot care knowledge and self-care practices among participants that completed the program. In addition, participants provided positive feedback regarding the design and delivery of the intervention.

Conclusion: Video storytelling may be a promising intervention to increase awareness of foot health and promote foot self-care behaviors in people with diabetes and elevated A1C levels.

Implication: By incorporating video storytelling interventions, nurse practitioners can engage patients with diabetes and elevated A1C levels in foot care education to prevent diabetes-related foot complications.
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NewsBot · Jun 20, 2026

Factors associated with foot self care behavior among older adults with recurrent diabetic foot ulcer: a cross-sectional study
Liping Lin et al
Front Endocrinol (Lausanne). 2026 Jun 3:17:1856183.

Background: Diabetic foot ulcers (DFU) are a severe complication of diabetes, with high recurrence rates and substantial clinical burden. Foot self-care behavior is essential for preventing ulcer recurrence, yet evidence specifically targeting older adults with recurrent DFU remains limited. This study aims to identify the factors associated with foot self-care behavior among older adults with recurrent diabetic foot ulcers.

Methods: A cross-sectional study was conducted using a purposive sampling technique among 170 older adults (≥60 years) with recurrent DFU recruited from the multidisciplinary diabetic foot clinics of three general hospitals in China between January 2023 and December 2024. The study adhered to the STROBE guidelines for cross-sectional studies. Data were collected using structured questionnaires, including the Nottingham Foot Care Assessment (NAFF), Foot Care Confidence Scale, Multidimensional Scale of Perceived Social Support, and Geriatric Depression Scale (GDS-15). Clinical characteristics were extracted from medical records. Multiple linear regression analysis was performed to identify factors associated with foot self-care behavior.

Results: The mean total NAFF score was 48.5 ± 10.2, indicating a moderate level of foot self-care. Foot care self-efficacy (β = 0.41, P < 0.001), receipt of foot care health education (β = 0.25, P = 0.001), perceived social support (β = 0.19, P = 0.008), and depressive symptoms (β = -0.17, P = 0.021) were factors associated with foot self-care behavior, collectively explaining 47.2% of the variance in foot self-care behavior (adjusted R² = 0.472).

Conclusion: Foot self-care behavior among older adults with recurrent DFU is moderate and is associated with modifiable psychosocial factors. Interventions targeting self-efficacy, health education, social support, and depressive symptoms may contribute to improved self-care and potentially reduce ulcer recurrence. Longitudinal and interventional studies are warranted to confirm these associations and evaluate clinical effectiveness.
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NewsBot · Jun 21, 2026

Examination of the Relationship Between Foot Care Behaviour, Self-Efficacy, and Diabetes Self-Care Among Individuals With and Without Diabetic Foot Wounds
Elif Boz, Eylem Topbaş
Scand J Caring Sci. 2026 Jun;40(2):e70243.

Aim: This study aimed to examine the relationship between foot care behaviours, self-efficacy and diabetes self-care activities among individuals with and without diabetic foot wounds and to identify associated sociodemographic and disease-related factors.

Methods: A cross-sectional study was conducted with 120 patients presenting to the internal medicine, endocrinology, and diabetic foot outpatient clinics and wards of three different hospitals. Data were collected using a demographic and clinical characteristics form, the Foot Care Behaviour Scale, Diabetic Foot Care Self-Efficacy Scale, and Diabetes Self-Care Scale. Data were analysed using IBM SPSS version 22, with Mann-Whitney U, Kruskal-Wallis H, independent samples t-test, ANOVA and correlation analysis applied as appropriate.

Results: Patients with and without diabetic foot wounds did not differ significantly in foot care behaviours or diabetes self-care scores (p > 0.05). However, diabetic foot care self-efficacy scores were significantly higher among patients without diabetic foot wounds (p < 0.05). In patients with diabetic foot wounds, prior foot care education was associated with significantly higher diabetic foot care self-efficacy and diabetes self-care scores (p < 0.05). Older age was negatively correlated with scale scores in both groups, whereas higher education level and certain preventive practices (e.g., foot self-examination, checking footwear) were significantly associated with better scores. Strong positive correlations were identified among foot care behaviours, diabetic foot care self-efficacy, and diabetes self-care across all participants (p < 0.05).

Conclusion: The strong positive associations among foot care behaviours, diabetic foot care self-efficacy, and diabetes self-care underscore the critical role of patient empowerment in disease management. The higher self-efficacy scores in patients without diabetic foot and those who were previously educated on their prevention demonstrate the importance of early, targeted nursing interventions. Implementing structured foot care education prior to the onset of complications may strengthen patient self-efficacy, improve self-care adherence and ultimately prevent the development of diabetic foot wounds.
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NewsBot · Jun 21, 2026

Insights Into Self-Care of Feet When Living With Diabetes: A Phenomenological Hermeneutic Interview Study
Kristofer Björk et al
J Clin Nurs. 2026 May 7.

Aim: To describe how persons with diabetes experience learning about self-care, with a particular focus on foot self-care.

Methods: Narrative, semi-structured interviews were conducted with persons diagnosed with Type 1 or Type 2 diabetes. Participants were recruited through an advertisement in a diabetes association magazine and through convenience and snowball sampling. Eleven participants aged 53-87 were interviewed between December 2024 and April 2025. Interviews were audio-recorded, transcribed verbatim and analysed using a phenomenological hermeneutic approach.

Results: Learning about foot self-care emerged as a gradual, lived process shaped by bodily experiences, social relationships and access to support. Three themes were identified: the social landscape of self-care, the being of the feet and taking knowledge into your own hands. Learning was influenced by encounters with healthcare professionals, informal support from relatives and personal experiences over time. Bodily symptoms acted as driving forces for learning and self-care actions. Understanding why self-care mattered was essential for motivation, while seeking and evaluating knowledge became a strategy for control and participation in care.

Conclusion: Learning about foot self-care among persons with diabetes is an embodied, relational and ongoing process. That develops through interaction among lived bodily experiences, social support and personal responsibility rather than through information alone.

Implications for the profession and/or patient care: Healthcare professionals must integrate persons' experience-based knowledge and support dialogue, reflection and shared learning to strengthen foot self-care practices.

Impact: The study addressed the limited understanding of how persons with diabetes learn foot self-care. The results showed that learning is shaped by lived experience, relationships and meaning-making. The findings are relevant for persons with diabetes and healthcare professionals involved in diabetes care.
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NewsBot · Jul 1, 2026

Barriers to Self-Management of Patients with Diabetic Foot Ulcers: A Systematic Review and Qualitative Meta-Synthesis
Qin Liu et al
Adv Skin Wound Care 2026 Jul 1;39(6):E276-E285. doi: 10.1097/ASW.0000000000000469

Objective: To synthesize qualitative research on self-management among patients with diabetic foot ulcers (DFUs) to provide insights and recommendations for enhancing self-management interventions.

Data sources: A comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, WanFang, and VIP databases was conducted through August 15, 2024.

Study selection: Studies were selected based on the PICo-D model; P (Population) was patients with DFUs, I (Interest) was barriers to self-management, Co (Context) was the patient's life following a DFU diagnosis, and D (Design) was qualitative or mixed-method studies. Exclusion criteria included duplicate publications, unavailable full text, and literature published in languages other than Chinese or English.

Data extraction: Two researchers independently screened, assessed quality, and extracted data. Discrepancies were resolved by discussion or a third reviewer. Extracted data included authors, year, country, methodology, sample size, phenomenon of interest, and key findings.

Data synthesis: A meta-synthesis approach integrated findings from 14 studies with 256 participants. Barriers to DFU self-management were grouped into eight themes: (a) cognitive factors (eg, lack of knowledge, information processing, decision-making abilities, self-efficacy); (b) emotional factors; (c) behavioral factors (eg, behavioral habits, adherence); (d) social factors (eg, social resources, social support); (e) economic factors; (f) environmental factors (eg, living environment, environmental support); (g) policy factors (eg, policy support, resource allocation, regulatory restrictions); and (h) cultural factors (eg, cultural identity, traditional beliefs).

Conclusions: Patients with DFUs face multiple barriers to effective self-management. Health care providers should focus on enhancing health education, providing psychological support, fostering a supportive environment, and implementing personalized interventions to improve patients' self-management abilities and strengthen their overall prognosis.
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NewsBot · Jul 1, 2026

The effectiveness of a foot-care education program based on multi-theory model in diabetic patients with risk of foot ulceration: A randomized controlled trial protocol
Huiwen Xu et al
PLoS One. 2026 Jun 15;21(6):e0350892

Background: Diabetic foot ulcer (DFU) is one of the most common and serious complications of diabetes mellitus (DM). The high disability and fatality rates of DFU raise the importance of early medical treatment. However, delays in seeking medical treatment among DFU patients are common, emphasizing the need for targeted health education. This study aims to evaluate the effectiveness of a Multi-Theory Model (MTM)-based foot care education program on improving healthcare decision-making and foot care behaviors in diabetic patients with risk of foot ulceration.

Method: A multicenter randomized controlled trial will be employed. Diabetic patients at risk of foot ulceration will be recruited from two different tertiary hospitals in different cities. Eligible participants will be randomly allocated to receive either routine education and a foot-care handbook (control group) or comprehensive foot-care education based on MTM (intervention group). The intervention period will last for 4 weeks, followed by a 3-month post-intervention follow-up. Questionnaire data and clinical data will be collected at baseline, immediately after the 4-week intervention, and at the 3-month follow-up. The primary outcome will be pre-hospital delay intentions. Foot care knowledge, foot care self-efficacy, and foot care behaviors will be investigated using questionnaires. Clinical data, including blood glucose, blood pressure, and body mass index (BMI), will also be assessed.

Discussion: Based on the MTM, this study developed a comprehensive foot-care education program for diabetic patients at risk of foot ulceration. By integrating systematic, theory-driven educational components, the program may equips both hospitals and community health services with a structured approach to deliver targeted foot-care education.
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NewsBot · Jul 1, 2026

Compliance With Foot Care Practices Among Patients With Diabetes Mellitus in Sudan
Izzeldin Ahmed Dawaud et al
Int Wound J. 2026 Jul;23(7):e70989.

Diabetes Mellitus (DM) is frequently complicated by Diabetic Foot Ulcers (DFUs), which contribute to high morbidity, mortality, and healthcare costs. Regular foot care and clinic follow-up can reduce the incidence of DFUs and related complications, yet adherence to these practices remains poorly described in Sudan. To assess compliance with foot care practices and identify factors associated with compliance and barriers to regular foot care clinic attendance among patients with diabetes attending the Jabber Abo Aliz Diabetes Care Center in Khartoum, Sudan. A cross-sectional descriptive study was conducted from December 2021 to February 2022 involving 120 patients with DM attending foot care clinics. Data were collected using structured questionnaires covering demographic and clinical characteristics, foot care behaviours, and perceived barriers. Compliance was measured using a Likert-based scoring system, with scores ≥ 9/17 classified as compliant. Data were analysed using SPSS version 21.0, applying Chi-square tests and ANOVA where appropriate, with statistical significance set at p < 0.05. Among 120 participants (55% female; mean age 49 ± 11 years), 70% were classified as compliant with foot care. Compliance was significantly associated with female gender (p = 0.043), age < 40 years (p = 0.034), urban residence (p = 0.037), higher socioeconomic status (p = 0.002), and good glycemic control (HbA1c ≤ 7%; p = 0.001). Duration of DM showed no significant association (p = 0.184). Transportation and distance were the most reported barriers to clinic attendance (30%). Most patients attending foot care clinics demonstrated good adherence to foot care practices, particularly those with favourable socioeconomic and clinical profiles. However, geographic and economic barriers continue to limit regular attendance. Strengthening outreach strategies, reducing access barriers, and integrating foot care education into routine diabetes management could improve outcomes and reduce DFU-related complications in Sudan.
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NewsBot · Jul 1, 2026

Effectiveness of foot care guidelines on preventive knowledge and self-care behaviors among patients with diabetic neuropathy: a quasi-experimental study
Fatma Abdou Eltaib et al
Front Med (Lausanne). 2026 Jun 16:13:1818326.

Background: Diabetic neuropathy, a debilitating complication of diabetes mellitus caused by prolonged hyperglycemia, is a significant chronic health problem in Saudi Arabia. This study aimed to evaluate the effectiveness of structured foot care guidelines in improving preventive knowledge and self-care practices among patients with diabetic neuropathy.

Methods: This quasi-experimental, single-group pre- and post-intervention study was conducted from October 2023 to September 2024 at the Specialized Diabetes Center of Prince Abdel Aziz Bin Messad Hospital in Arar, Northern Border Region, Kingdom of Saudi Arabia. The study involved 40 adults with peripheral neuropathy selected through purposive sampling. The intervention included implementing the International Working Group on the Diabetic Foot (IWGDF) guidelines for diabetic patients with neuropathy, and data were collected using questionnaires to assess sociodemographic characteristics, adherence to foot care practices, and the presence of distal symmetrical peripheral neuropathy.

Results: Statistical analysis using SPSS version 23 with descriptive and inferential statistical techniques showed a significant improvement (p < 0.02) in patients' preventive foot care knowledge and self-care behaviors, along with improvements in neuropathy symptom reporting. The mean age of the participants was 65.35 ± 11.84 years; 65% were female patients and 35% were male patients.

Conclusion: Structured foot care guidelines had a significant positive impact on patients' knowledge, foot care behaviors, and reported neuropathy symptoms. These findings underscore the importance of ongoing educational and training programs to enhance foot care practices and increase awareness of the importance of reporting neuropathy-related complications.
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NewsBot · Jul 2, 2026

Self-Monitoring Risk Factors for Diabetic Foot Ulceration With the Feetchecker App: Mixed Methods Study
Roy van den Heuvel et al
JMIR Form Res. 2026 May 27:10:e80769. doi: 10.2196/80769.

Background: A prevalent and serious complication of diabetes mellitus is the development of diabetic foot ulcer (DFU). There is a need for effective solutions that help prevent DFU to support our increasingly stressed health care systems. The use of mobile health (mHealth) tools has been shown to improve awareness and effective self-care management skills in people at risk of developing diabetic foot ulceration.

Objective: In this study, we aimed to investigate the perceived usefulness, engagement, and overall user experience of the Feetchecker app, a self-monitoring mHealth app for people at risk of DFU.

Methods: A total of 24 patients (mean age 71, SD 8.6 years) with type 2 diabetes mellitus at risk of developing diabetic foot ulceration completed a 3-month evaluation period (70 recruited, 36 included, 12 dropped out) of a self-monitoring mobile app called Feetchecker app. A mixed methods approach was used to combine insights from app data with qualitative data from a pre- and postsurvey as well as interviews with patients and involved podiatrists. Data were analyzed using descriptive statistics and thematic analysis. We evaluated overall use of the app, patient engagement, and user experiences.

Results: Patients who fully completed the study conducted 393 feetchecks. In total, 7 patients sent in 9 pictures; all 7 were called for follow-up by a podiatrist. Overall, patients had a positive experience with the app and perceived the Feetchecker app as a valuable tool to monitor their feet for potential risk factors of DFU. Ease of use in performing a feetcheck and sending the podiatrist a picture was described as an important feature. Three main types of engagement with the Feetchecker app emerged: continuous, frequent, and no to little engagement. These patterns highlight enablers for self-monitoring such as ease-of-use, easy access to a podiatrist, and social support, as well as barriers such as digital skills and sustained engagement. Podiatrists highlighted the benefits of having patients report potential issues quicker and the ability to monitor their patients remotely. Challenges remain in integrating the promotion of the Feetchecker app into their consultations.

Conclusions: The Feetchecker app supported patients in self-monitoring risk factors associated with DFU through routine checks and quick contact with a health care professional in case of a potential issue. Overall, patients described a positive user experience and considered the app helpful. While mHealth tools are not for everyone, user engagement for many patients was high and shows that such apps can offer support for people able to use them. Future research should focus on improving usability and engagement with the app as well as extend the way patients can communicate with health care professionals beyond a picture.
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NewsBot · Jul 9, 2026 at 8:01 PM

The relationship between digital health literacy, self-efficacy, and self-management behaviors in patients with diabetes-related foot disease: a cross-sectional study
Jianxia Yao et al
Front Public Health. 2026 Jun 24:14:1850957.

Objective: This study aimed to explore the relationship among digital health literacy, self-efficacy, and self-management behaviors in patients with diabetes-related foot disease (DRFD), and to analyze the mediating role of self-efficacy.

Methods: A cross-sectional survey was conducted from February 2024 to December 2025 among 328 patients with DRFD in a endocrinology department of tertiary hospital. Participants were recruited using a consecutive sampling method and completed a general information questionnaire, the eHealth Literacy Scale (eHEALS), the Diabetes Management Self-Efficacy Scale (DMSES), and the Diabetic Foot Self-Management Behavior Scale (DFSMBS). Mediation analysis was performed using the SPSS Process Macro (Model 4), with bootstrap resampling (5,000 iterations) to calculate 95% confidence intervals. The study was conducted in accordance with the STROBE guidelines.

Results: Digital health literacy was moderately positively correlated with self-management behaviors (r = 0.42, p < 0.01). Self-efficacy was strongly positively correlated with self-management behaviors (r = 0.53, p < 0.01). These associations remained significant after controlling for potential confounding variables (including age, disease duration, and Wagner grade). Furthermore, self-efficacy partially mediated the relationship between digital health literacy and self-management behaviors, with a mediation effect of 0.23 [95% CI (0.156, 0.328)], accounting for 41.8% of the total effect.

Conclusion: Improving digital health literacy in patients with DRFD is directly associated with better self-management behaviors and is indirectly associated with them through increased self-efficacy. Clinical practice should integrate digital health education with psychological empowerment strategies to optimize self-management.
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NewsBot · Jul 10, 2026 at 12:40 AM

Evaluation of diabetic foot care knowledge, determinants of self-care practices and the efficacy of health education
Xiaomei Xu et al
Int Wound J. 2024 Feb;21(2):e14704.

To evaluate the risk factors connected with diabetic foot care and investigate the impact of health education on promoting proper diabetic foot care practices. An explanatory and mixed-method study was performed. We administered a structured pretest questionnaire to patients diagnosed with Type 2 diabetes who frequented our health examination center and community health clinics. The survey encompassed patient demographics, basic knowledge concerning diabetic foot care, and self-care practices pertaining to diabetic foot care. Concurrent assessments and scoring were carried out. Following the survey, patients underwent health education sessions focusing on foot self-care behaviours. Their progress was reevaluated after 2 weeks to gauge its effectiveness. We identified educational attainment, diabetes duration, regular follow-up, and blood sugar control as critical factors influencing knowledge about foot care and self-care practices related to it. Pearson correlation analysis demonstrated a positive relationship between scores for diabetic foot care knowledge and scores for self-care behaviours (r = 0.32, p < 0.001). Health education led to a significant improvement in the self-care behaviours of diabetic patients. A variety of factors affect the occurrence of diabetic foot complications and the self-care behaviours associated with diabetic foot care. Health education proves to be an effective means of enhancing diabetic foot care behaviours.
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Diabetic foot self care

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MyFootCare: An application to actively engage people in their diabetic foot ulcer self-care

Mobile app for Diabetic Foot Self-Care

Validation of a booklet on self-care with the diabetic foot

Bisphenol A exacerbates diabetic foot ulcers

Hyodine for Diabetic Foot Ulcers

Kinesiophobia in patients with diabetic foot ulcers

Dermomina® clay achieves high closure rates in non-infected diabetic foot ulcers

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Diabetic foot self care

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MyFootCare: An application to actively engage people in their diabetic foot ulcer self-care

Mobile app for Diabetic Foot Self-Care

Validation of a booklet on self-care with the diabetic foot

Bisphenol A exacerbates diabetic foot ulcers

Hyodine for Diabetic Foot Ulcers

Kinesiophobia in patients with diabetic foot ulcers

Dermomina® clay achieves high closure rates in non-infected diabetic foot ulcers

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