Nursing

Permanent URI for this collectionhttps://repository.chuka.ac.ke/handle/123456789/23583

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Browsing Nursing by Subject "Preventive practices"

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    Effect of diabetes foot care education on preventive practices among patients attending Embu and Kerugoya level five hospitals, Kenya
    (Chuka University, 2025) Mbisi Annastacia Munzi
    Diabetic foot disease, often known as ulceration (DFU) is a common complication among patients with Diabetes Mellitus(DM). An estimated 2 million amputations occur each year due to diabetic foot complications. In Kenya, the incidence of diabetic foot illness was 9.04% in 2020. Diabetic foot care (DFC) practice has the potential of reducing DFUs by 75%. Effective DFC practice requires that the patients have the requisite knowledge. Therefore, the purpose of this study was to determine the effect of diabetic foot care education on preventive practices among diabetes patients attending Embu and Kerugoya level five Hospitals-Diabetes clinics. The two facilities were purposely selected based on the previous data supporting poor foot care practices. A Randomized Controlled Trial (RCT) design involving three phases: Baseline survey, intervention and evaluation phase was adopted. Systematic random sampling strategy was used to select 230 participants for the study. A research administered questionnaire was used to collect quantitative data while focus group discussion (FGD) guide to collect qualitative data. Pre-testing of these instrument was done at Chuka level five hospital. During the baseline survey quantitative and qualitative data was collected using questionnaire and four (4) FGD-each with 10 participants respectively. In the intervention phase, the study population was divided into an intervention and control group. Structured foot care education was provided to patients in the intervention group in groups of 25 patients after every one month for a period of three months. The patients in the control group received normal services. In the evaluation phase, data was collected using the same tool as was used in the baseline survey for both the control and the intervention group. Statistical package for social sciences(SPSS) version 29.0 was utilized for the analysis of quantitative data while a thematic analysis of the qualitative data will be conducted with NVIVO version 14 software. Ethical approval was obtained from Chuka University and the National Commission for Science, Technology and Innovation (NACOSTI), with additional permissions from relevant hospitals. Informed consent was obtained from all participants, with confidentiality and anonymity strictly maintained. Data was securely stored and used solely for research purposes. Baseline results in both group generally revealed majority had inadequate foot care knowledge (n=111, 48%), poor foot care behavior (n=172, 75%) and low self-efficacy (n=132, 58%). FGD findings highlighted key barriers to diabetic foot care, including limited education, high healthcare costs, and staff shortages, while also identifying peer support, flexible clinic schedules, and friendly staff as key enablers. Following the educational program, only slight changes were observed in the control group; however, the intervention group showed marked improvements, with statistically significant differences in mean scores between the two groups in knowledge (Δ = 2.21; 95% CI: 1.27–1.14; p < 0.001), behavior (Δ = 1.02; 95% CI: 1.09–0.96; p < 0.001), and selfefficacy (Δ = 1.63; 95% CI: 1.76–1.50). Thus, the structured diabetic foot care (DFC) education intervention significantly enhanced knowledge, behavior, and self-efficacy among participants in the intervention group. These results confirm that a structured, culturally appropriate, and interactive educational approach is an effective strategy to empower patients, encourage preventive practices, and lower the risk of diabetic foot complications. Consequently, the study recommends that nurses incorporate structured foot care education sessions into routine diabetes clinic visits. Future research should explore its long-term impact on foot ulcers, hospitalizations, and amputations