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Effect of Self-Efficacy Enhancing Intervention Training on Clinical Health Status of Diabetic Patients at High-Risk for Leg Problems

Zeinab Hussen Ali

Egypt has more diabetic individuals than any other country, with high incidence of foot problems and amputations. This study was aimed at evaluating the effect of a self-efficacy enhancing intervention training (SEEIP) on the clinical health status of diabetic patients at high risk for leg problems. The study was conducted in the diabetic outpatient clinic in Ain-Shams Specialized University Hospital in using a randomized controlled trial study design. It included a sample of 60 diabetic patients randomized an intervention group of 30 patients to attend the program and an equal control group following the routine diabetic care in the setting. The data collection tools were an interview questionnaire sheet, and adiabetes clinical/lab form, the self-efficacy assessment form for diabetic patients, and a leg physical assessment sheet. The study was carried out through preparatory, assessment, planning, implementation, and evaluation phases. The training intervention consisted of five efficacy-enhancing sessions at weekly intervals. For evaluation, two posttests were carried out at one and six months after the end of the program. The work was from September 2014 to August 2015. The study revealed statistically significant improvements in the study group at the post- and follow-up in lower limb physical findings (p<0.001), compliance with medications, more days of intake of medications, of following diet, exercise, and practicing foot care during last week (p<0.001), perception of health, and self-confidence (p<0.001), hypertension (p<0.001), random blood sugar (p<0.001), glycated Hb (p<0.001), and total cholesterol (p=0.001). There were statistically significant positive correlation between the scores of self-confidence and foot self-care (r=0.96), and between the number of abnormal signs and the level of HbA1c, while the total number of abnormal signs correlated negatively with the score of self-confidence and foot self-care. The level of HbA1c, it correlated negatively with the scores of self-confidence and foot self-care. In conclusion, increasing diabetic patients’ self-confidence and self-efficacy can improve their self-care practices, with subsequent positive impacts on their general and feet health status and diabetic control. The implementation of self-efficacy enhancing training programs is recommended with the use of the developed illustrated booklet as an educational aid for diabetic patients whom at risk for leg problems. More research is needed to investigate the longterm effect of such educational interventions.