Educational Interventions on Diabetic Foot Care

NCT ID: NCT04811989

Last Updated: 2022-05-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-08

Study Completion Date

2021-12-31

Brief Summary

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Diabetes mellitus currently affects 463 million people worldwide. One of the most serious complications of diabetes is the diabetic foot. Adequate foot care behaviours reduce the risk of ulcers, infections, and amputations, and improve the quality of life, in these patients.

This Pragmatic Randomized Controlled Trial aims to analyse the impact of different educational strategies - an instructive video (Video Watching Group - Experimental Group 1) compared with a leaflet on foot care with real-time guided reading (Real-Time Leaflet Reading Group - Experimental Group 2) and with standard teaching on diabetic foot care (Standard Care - Control Group) - on adherence and knowledge regarding diabetic foot care, as well as on patient's perception of their foot health. Participants will be assessed at the first consultation of the diabetic foot (T0), about two weeks after the first assessment (T1), and three months after the T0 in a follow-up assessment (T2), with T1 and T2 being performed through telephone calls, after obtaining the patients' consent.

The results of the present study will inform educational interventions regarding foot care adherence in patients with diabetic foot, in order to decrease the likelihood of developing diabetic foot ulcers and, consequently, to reduce amputation rates and the several associated costs, contributing to improving patients' quality of life.

Detailed Description

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Specific Aims

1. To analyze the contribution of sociodemographic, clinical, and psychological variables to diabetic foot care adherence and knowledge, and perceived foot health, over time.
2. To analyze the differences between groups over time in diabetic foot care adherence, knowledge on foot care, and perceived foot health.
3. To examine the mediating role of representations about diabetic foot in the relationship between knowledge about foot care and adherence to diabetic foot care, over time, controlling for health literacy.
4. To examine the moderating role of foot pain, foot function, and footwear between representations about diabetic foot and adherence to diabetic foot care/ perceived foot health, over time.

Data Analysis:

Generalized Mixed Models, which allow examining changes over time including longitudinal mediation and moderation.

Sample size calculation:

Considering a dropout rate of 10%, the sample size required is 60 patients (20 per group).

Procedure:

Participants will be assessed at the first consultation of the diabetic foot (T0), about two weeks after the first assessment (T1), and three months after the T0 in a follow-up assessment (T2), with T1 and T2 being performed through telephone calls.

Conditions

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Diabetes Mellitus Diabetic Foot

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized at a ratio of 1:1 for the two conditions - Video Watching Group or Real-time Leaflet Reading Group versus Standard Care Group - into blocks of variable size, multiples of two. This randomization will be stratified according to the hospital (hospital 1 versus hospital 2) and the presence or absence of active diabetic foot ulcer.
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants
Randomisation will be performed through an online random number generator, by a researcher external to the team of this study, to ensure the concealment of the allocation of participants by the several groups (Pandis, 2012). It will not be possible to conceal the group to which the patient was allocated to the medical and nursing team, since they have to administer the intervention or the researcher who will have to inform the respective team and administer the intervention in the Reading Group. Only the participants will be blind to the group to which they have been allocated.

Study Groups

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Video Watching Group

Participants will watch an instructive video on diabetic foot care and will receive face-to-face teaching on diabetic foot care.

Group Type EXPERIMENTAL

Instructive video on diabetic foot care

Intervention Type BEHAVIORAL

In the video, the diabetic foot care is presented verbally and appropriately captioned, as well as exemplified by real patients and health professionals from the hospital

Face-to-face teaching

Intervention Type BEHAVIORAL

Face-to-face teaching includes the teaching about diabetic foot care during the consultation by health professionals.

Real-time Leaflet Reading Group

Participants will receive a leaflet with diabetic foot care information, whose reading will be guided in real-time by the Researcher, and will also receive face-to-face teaching on diabetic foot care.

Group Type EXPERIMENTAL

Informative leaflet with real-time guided reading

Intervention Type BEHAVIORAL

The leaflet has information about diabetic foot care. Researcher will guide its reading with patients.

Face-to-face teaching

Intervention Type BEHAVIORAL

Face-to-face teaching includes the teaching about diabetic foot care during the consultation by health professionals.

Standard Care Group

Participants will receive the standard care that includes face-to-face teaching about diabetic foot care and will take a leaflet on diabetic foot care to read at home.

Group Type ACTIVE_COMPARATOR

Informative leaflet to read at home

Intervention Type BEHAVIORAL

Patients receive a leaflet about diabetic foot care to read at home.

Face-to-face teaching

Intervention Type BEHAVIORAL

Face-to-face teaching includes the teaching about diabetic foot care during the consultation by health professionals.

Interventions

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Instructive video on diabetic foot care

In the video, the diabetic foot care is presented verbally and appropriately captioned, as well as exemplified by real patients and health professionals from the hospital

Intervention Type BEHAVIORAL

Informative leaflet with real-time guided reading

The leaflet has information about diabetic foot care. Researcher will guide its reading with patients.

Intervention Type BEHAVIORAL

Informative leaflet to read at home

Patients receive a leaflet about diabetic foot care to read at home.

Intervention Type BEHAVIORAL

Face-to-face teaching

Face-to-face teaching includes the teaching about diabetic foot care during the consultation by health professionals.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of Diabetes mellitus;
* Diagnosis of Diabetic Foot;
* To benefit from the first assessment and follow-up at the Multidisciplinary Diabetic Foot Consultation of the hospitals where data collection will take place.

Exclusion Criteria

* Presence of clinical dementia described in the patient's clinical record;
* Cognitive disability to answer the questionnaires;
* Severe visual and/or hearing impairment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Foundation for Science and Technology, Portugal

OTHER

Sponsor Role collaborator

University of Minho

OTHER

Sponsor Role lead

Responsible Party

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Gabriela Ferreira

Principal Investigator, Master

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gabriela Ferreira, Master

Role: PRINCIPAL_INVESTIGATOR

School of Psychology, University of Minho

Locations

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Clínica do Pé Diabético, Centro Hospitalar do Tâmega e Sousa

Penafiel, Porto District, Portugal

Site Status

Centro Hospitalar Universitário do Porto

Porto, , Portugal

Site Status

Countries

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Portugal

References

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Bastos F, Severo M, Lopes C. [Psychometric analysis of diabetes self-care scale (translated and adapted to Portuguese)]. Acta Med Port. 2007 Jan-Feb;20(1):11-20. Epub 2007 May 23. Portuguese.

Reference Type BACKGROUND
PMID: 17624279 (View on PubMed)

Bennett PJ, Patterson C, Wearing S, Baglioni T. Development and validation of a questionnaire designed to measure foot-health status. J Am Podiatr Med Assoc. 1998 Sep;88(9):419-28. doi: 10.7547/87507315-88-9-419.

Reference Type BACKGROUND
PMID: 9770933 (View on PubMed)

Figueiras M, Marcelino DS, Claudino A, Cortes MA, Maroco J, Weinman J. Patients' illness schemata of hypertension: the role of beliefs for the choice of treatment. Psychol Health. 2010 Apr;25(4):507-17. doi: 10.1080/08870440802578961.

Reference Type BACKGROUND
PMID: 20204931 (View on PubMed)

Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc. 2009 Oct;59(10):687-90.

Reference Type BACKGROUND
PMID: 19813683 (View on PubMed)

Lincoln, N. B., Jeffcoate, W. J., Ince, P., Smith, M., & Radford, K. A. (2007). Validation of a new measure of protective footcare behaviour: the Nottingham Assessment of Functional Footcare (NAFF). Practical Diabetes International, 24, 207-211. doi:10.1002/pdi.1099

Reference Type BACKGROUND

Paiva D, Silva S, Severo M, Ferreira P, Santos O, Lunet N, Azevedo A. Cross-cultural adaptation and validation of the health literacy assessment tool METER in the Portuguese adult population. Patient Educ Couns. 2014 Nov;97(2):269-75. doi: 10.1016/j.pec.2014.07.024. Epub 2014 Jul 22.

Reference Type BACKGROUND
PMID: 25107513 (View on PubMed)

Pandis N. Randomization. Part 3: allocation concealment and randomization implementation. Am J Orthod Dentofacial Orthop. 2012 Jan;141(1):126-8. doi: 10.1016/j.ajodo.2011.09.003. No abstract available.

Reference Type BACKGROUND
PMID: 22196195 (View on PubMed)

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000 Jul;23(7):943-50. doi: 10.2337/diacare.23.7.943.

Reference Type BACKGROUND
PMID: 10895844 (View on PubMed)

Other Identifiers

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CEICVS134/2020

Identifier Type: -

Identifier Source: org_study_id

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