THE EFFECT OF A SELF-MANAGEMENT SUPPORT PROGRAM ON THE ACHIEVEMENT OF GOALS IN DIABETIC FOOT CARE BEHAVIORS IN INDONESIAN DIABETIC PATIENTS
ABSTRACT: Diabetic foot care
behaviors (DFCB) are a fundamental component of the prevention of diabetic foot
complications. This quasi-experimental study aimed to examine the effect of a
self-management support program on the achievement of DFCB goals in Indonesian
diabetic patients.
Method: Thirty-five subjects were recruited from the diabetic unit of a
district hospital in West Java, Indonesia. The subjects received a five-week
diabetic foot care self-management (SM) support program. This program consisted
of three sequential phases based on the self-management method proposed by
Kanfer and Gaelick-Buys (1991): self-monitoring, self-evaluation, and
self-reinforcement. The strategies used in this program consisted of individual
foot care education, goal setting and action planning, and brief weekly
counseling and follow-ups. The goals achieved from the second to the fourth
weeks were evaluated weekly by phone call follow-ups with a face-to-face
interview evaluation in the fifth week. The level of goal achievement was
determined by counting the number of successfully implemented actions based on
the subject’s action plans. The actual goal achievement was then classified
into three levels: goal completely achieved, goal partially achieved and no behavioral
change (no action) at all.
Results Most of the subjects (94.3%) were able to completely achieve
their first week goals whereas only approximately two-thirds of the subjects
were able to completely achieve their goals in the second to the fourth weeks.
Throughout the program, less than half of the subjects (42.9%) completely
achieved all four weekly goals although only one subject (2.9%) was unable to
achieve any of the weekly goals. The most improved DFCB component in each of
the first to fourth weeks was foot hygiene, footwear, toenail care and a
combination of foot hygiene and footwear, respectively.
Conclusion: This SM support program effectively improved the Indonesian
diabetic patients’ foot care behaviors. Therefore, nurses can apply this program
in practice in enhancing DFCB in order to prevent diabetic foot ulceration.
Journal Code: jpkeperawatangg110013