INTRODUCTION:

India is the diabetic capital of the world. Forty one million Indians having diabetes. Every fifth diabetic in the world is an Indian. There were one million deaths due to Diabetes mellitus in 2015. More than 80% of diabetic death occurs in low and middle income countries. (Gopinath & Rajan, 2017).

Diabetic foot ulcer is a result of micro and macro vascular complications in diabetes mellitus. Diabetic foot problems are the leading cause of diabetes-related hospital admissions and are responsible for approximately 50% of all lower limb amputation worldwide. Majority of patients are unaware about the importance of foot care and its consequences. Self management education programs for people with diabetes about healthy foot care measures decrease the occurrence of diabetic foot complications like foot ulcers. Patients with poor knowledge and practices about diabetic foot care have a higher incidence of diabetic foot complications. (Saber, H.J and Daoud, A. S, 2019). Education makes the clients to improve the knowledge and practice regarding diabetic foot care.

LITERATURE REVIEW:

Das and Mishra (2016) evaluated the effectiveness of structured teaching programme in terms of knowledge regarding diabetic foot care among diabetic patients in selected hospital, Indore. The aim of the study was to evaluate the effectiveness of structured teaching programme. A pre experimental, one group pre-test post-test research design was carried out on 30 diabetic patients of Bombay Hospital, Indore. Self-administered close ended questionnaire were used to assess the knowledge regarding diabetic foot care before and after administering structured teaching programme. The results showed that there was significant difference between pre-test and post-test knowledge score, as calculated t value 8.89 revealed p<0.05.

Kanade and Zagade (2013) conducted a study to assess the effectiveness of planned teaching programme on knowledge regarding foot care among diabetic clients. A quasi experimental method with a description of research approach, the researcher conducted study in a selected hospital, among the 30 clients. Who gave consent for study and were selected through non probability convenient sampling technique. A self-administered structured knowledge questionnaire and planned teaching programme used. To find the effectiveness of planned teaching programme the t- test was applied and ‘t’ value was calculated the mean post test score were significantly higher than their mean pre-test score as evidenced from structured knowledge test ‘p’>0.001 level of significance. The mean percentage of pre-test was 7.86 and the mean percentage of post-test was 15.7. The knowledge of the target population was significantly improved after receiving information in the form of planned teaching programme on diabetic foot care.

Tamilselvi, Rajasankarand Kokilavani (2013) conducted a study to assess the knowledge Regarding Diabetic foot Ulcer among Diabetic Clients in a selected Hospital, Kancheepuram District, Tamil Nadu. Convenient sampling technique was used to select 100 diabetic patients who were in hospital. Data were gathered through structured knowledge questionnaire. The results mainly found that 56% patients had inadequate level of knowledge,38% had average level of knowledge,6%had an adequate level of knowledge. The Association between knowledge score and demographic variables was assessed by using chi-square. There was significant association between age, sex, marital status and family history of diabetes with knowledge score. The findings revealed that there is need planned teaching programme regarding diabetic ulcer foot.

STATEMENT OF THE PROBLEM:

Effectiveness of Structured Teaching Programme on Knowledge Regarding Foot Care Among Patients with Diabetes Mellitus at Selected Hospital, Coimbatore.

OBJECTIVE:

1 To assess the knowledge about foot care among diabetic patients.

2 To evaluate the effect of structured teaching programme on foot care among diabetic patients.

3 To find out the association between level of knowledge on foot care with selected demographic variables.

Hypothesis:

H₁: There is a significant difference in level of knowledge on foot care among diabetic patients before and after the structured teaching programme

H₂: There is a significant association between the demographic variables and level of knowledge on foot care among patients with diabetes mellitus.

MATERIAL AND METHODS:

Pre experimental one group pre testpost test design was adopted for the study. 60 diabetes mellitus patients were selected by using purposive sampling technique. The demographic profile was collected from the patients. Pretest was conducted to assess the level of knowledge by using a structured questionnaire. One to one education was given to diabetic patients by using a structured teaching programme. Post test was conducted after 5 days.

ANALYSIS:

Demographic data was analyzed using frequency and percentage. Frequencies, percentage, mean, median, mean percentage and standard deviation was used to determine the knowledge score. The ‘T’ value was computed to show the effectiveness of structured teaching programme and chi-square test was done to determine the association between the pre-test knowledge with selected demographic variables.

FINDING:

In this study overall the highest percentage in the demographic data including the Age group 28.33% (46-55y), Gender 53.33% (Male), Educational status 31.67% (iliterate), occupational status 45% (housewives), monthly family income 60% (5000-10,000), family history of diabetes mellitus 78.33% (No), duration of patients with diabetes mellitus 80% (1-10), personal bad habits 51.67% (None), previous history of hospitalization due to diabetes mellitus 83.33% (No) and co-morbid illness 50% (cardiac problems).

Table 1: Assessment on the Level of Knowledge on Diabetic Foot Care among Patients with Diabetes Mellitus n=60

S. Ṇo	Level of knowledge	Number of Patients
		Pre test		Post test
		Frequency	(%)	Frequency	(%)
1 2 3	Inadequate Moderately adequate Adequate	36 21 3	60 35 5	25 31 4	41.67 51.66 6.67

Table 1 shows that distribution of the level of knowledge about diabetic foot care among patients with diabetes mellitus. In pre-test, 36 (60%) patients had inadequate knowledge, 21 (35%) had moderately adequate knowledge and 3 (5%) patients had adequate knowledge. In post-test, 25 (41.67%) patients had inadequate knowledge, 31 (51.66%) patients had moderately adequate knowledge and 4(6.67%) patients had adequate knowledge.

Table 2: Effect of Structured Teaching Programme on Level of Knowledge on Diabetic Foot Care among Patients with Diabetes Mellitus n=60

S. No.

Study groups

Mean

Mean difference

Calculated ‘t’ value

Table

value

Pre test

Post test

8.73

10.1

3.64

3.40

1.37

10.70*

1.96

Table 2 shows the effect of structured teaching programme about diabetic foot care on the level of knowledge among patients with diabetes mellitus. The result of the study shows that, the mean level of knowledge score was 8.73 and 10.1 respectively with the mean difference of 1.37. Standard deviations were 3.64 and 3.40. The calculated ‘t’ value 10.70 was greater than the table value at 0.05 level of significance. Hence the research hypothesis: “There is a significant difference in the level of knowledge on diabetic foot care among patients with diabetes mellitus was accepted”.

Association between the Levels of Knowledge among Patients with Diabetes Mellitus:

The association between the level of Knowledge and socio demographic variable among patients with diabetes mellitus for age, educational status, occupational status, family income and co-morbid illness is significant at the 0.05 level of significance.

CONCLUSION:

Diabetic foot ulcer is a result of micro and macro vascular complications in diabetics. Adoption of foot care practices to reduce the foot problems in diabetic patients. Education makes the clients to improve the knowledge and practice regarding diabetic foot care. Hence, the structured teaching programme was an effective method for providing moderate to adequate knowledge regarding diabetic foot care. If regular follow up for the foot care is adopted by the diabetic patients that can be helpful to reduce the risk of foot ulcers.

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Received on 24.09.2019 Modified on 07.10.2019

Int. J. of Advances in Nur. Management. 2019; 7(4): 336-338.

DOI: 10.5958/2454-2652.2019.00078.7