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Parinya Kaewsongk Khemaradee Masingboon Pawana Keeratiyutawong Melkus Gail D’Eramo Wannee Deoisres


            Foot care behaviors play an important role in preventing of diabetic foot complications. Unfortunately, many diabetes people do not have foot care properly. Simple interrupted time-series design was conducted to test efficacy of self-management support [SMS] program on foot care knowledge, foot care behaviors, perceived social facilitation support, and HbA1c among people with type 2 diabetes at low risk of diabetic foot complications. Forty-two participants from the outpatient diabetes clinic of the Police General Hospital who met inclusion criteria were recruited into the study by simple random sampling. Four-week SMS program was developed based on individual and family self-management theory (Ryan & Sawin, 2009) and empirical studies. Study outcomes including diabetic foot care knowledge, diabetic foot care behaviors, perceived social facilitation support, and HbA1c were measured before receiving SMS program at Time 1 and Time 2 and after receiving the program at Time 3 and Time 4. Outcomes were gathered by questionnaires and blood test of HbA1c.  Data were analyzed by descriptive statistics, repeated measure MANOVA, and dependent t-test.

            Results revealed that there were significant differences over time for all outcomes variables (F(9,394)=8.39, p<.001). But there were no changes on outcome variable mean scores before receiving SMS program at Time 1 and Time 2. Significant increased mean scores of foot care knowledge, foot care behaviors, and perceived social facilitation support from Time 1 before receiving the program to Time 4 after receiving the program was observed. In addition, HbA1c was significantly decreased from 8.1 % at Time 1 before receiving the program to 7.4 % at Time 4 after receiving the program.

            Findings suggest that SMS program is beneficial for type 2 diabetic people at low risk of diabetic foot complications. It would result in increasing perceived social facilitation support, sustaining self-management behaviors, improving glycemic control, and properly performing foot care. Therefore, SMS program should be integrated as a part of routine diabetes nursing care for preventing or delaying diabetic foot complications among this population.

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