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NCT Number: NCT07563751

Effectiveness of a Structured Educational Program on Pain Intensity, Self-Efficacy, Foot Self-Care Behaviors, and Health-Related Quality of Life Among Adults With Diabetic Foot

This randomized controlled trial aims to evaluate the effectiveness of a structured educational program on pain intensity, self-efficacy, foot self-care behaviors, and health-related quality of life among adults with diabetic foot. Diabetic foot complications are a major cause of morbidity, reduced quality of life, and disability among patients with diabetes mellitus. Poor self-care practices and inadequate knowledge contribute significantly to the progression of foot ulcers and related complications.

Participants will be randomly assigned to either an intervention group or a control group. The intervention group will receive a structured educational program designed to improve knowledge, self-management skills, and adherence to recommended diabetic foot care practices. The control group will receive routine care provided by the healthcare facility.

The educational program focuses on key areas including foot hygiene, daily foot inspection, appropriate footwear, glycemic control, and early identification of warning signs of complications. The primary outcomes of the study include changes in pain intensity, self-efficacy, foot self-care behaviors, and health-related quality of life, which will be assessed at baseline and after the intervention period.

The findings of this study are expected to contribute to improving nursing educational interventions and enhancing self-management outcomes among patients with diabetic foot.

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Key information

Conditions

Diabetic Foot Cardiovascular Diseases Diabetes Complications Diabetes Mellitus Diabetic Angiopathies Diabetic Neuropathies Endocrine System Diseases Foot Ulcer Leg Ulcer Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms Skin Diseases Skin Ulcer Skin and Connective Tissue Diseases Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ministry of Health Primary Healthcare Centers

Jerash, Dours, 009627, Jordan

Location contact

Jawad AHMAD ABU-SHENNAR, Asst.Prof.Dr

CONTACT

[email protected]

0779084560

Jawad AHMAD ABU-SHENNAR, Asst.Prof.Dr

PRINCIPAL_INVESTIGATOR

CONTACT

[email protected]

About this study

Diabetic foot is one of the most serious and common complications of diabetes mellitus, often leading to infection, ulceration, hospitalization, and in severe cases, lower limb amputation. It significantly affects patients' physical, psychological, and social well-being, thereby reducing overall quality of life. Despite the availability of preventive guidelines, many patients continue to demonstrate inadequate foot self-care behaviors, poor adherence to management recommendations, and low self-efficacy in managing their condition.

This study is designed as a randomized controlled trial to assess the effectiveness of a structured educational program on improving clinical and behavioral outcomes among adults with diabetic foot. The study will be conducted at selected healthcare settings, and eligible participants will be randomly allocated into either an intervention group or a control group using a predefined randomization method.

The intervention group will receive a structured educational program delivered through planned teaching sessions. The program is based on evidence-based diabetic foot care guidelines and includes theoretical and practical components. Topics covered include diabetic foot anatomy and risk factors, daily foot inspection techniques, proper hygiene practices, nail and skin care, appropriate footwear selection, wound prevention strategies, glycemic control, and early recognition of complications. Educational materials such as brochures, demonstrations, and interactive discussions will be used to enhance understanding and adherence.

The control group will receive routine care and standard education provided by the healthcare facility without additional structured intervention.

Outcome measures will be assessed at baseline and post-intervention. The primary outcomes include:

Pain intensity measured using a validated pain scale Self-efficacy assessed through a standardized self-efficacy instrument Foot self-care behaviors measured using a diabetic foot care behavior scale Health-related quality of life assessed using a validated quality of life questionnaire

Data will be analyzed to determine the effectiveness of the structured educational program in improving these outcomes compared to routine care.

The study is expected to provide evidence supporting the integration of structured educational programs into nursing practice to improve self-management, reduce complications, and enhance quality of life among patients with diabetic foot.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18 years and older
  • Diagnosed with diabetic foot
  • Able to communicate effectively
  • Willing to participate in the educational program
  • Able to provide written informed consent

Exclusion criteria

  • Patients with severe or unstable medical conditions (e.g., advanced heart failure, renal failure, or active infections) that may interfere with participation
  • Patients with major lower-limb amputation or severe foot deformities preventing participation in the educational program or assessments
  • Patients with cognitive impairments, psychiatric disorders, or communication difficulties affecting understanding or compliance
  • Pregnant or lactating women
  • Patients who refuse to provide informed consent or withdraw at any stage of the study

Treatment and study plan

Structured Educational Program

Behavioral

A structured educational program designed for adults with diabetic foot to improve self-care practices and disease management. The program includes planned teaching sessions delivered by trained nursing staff and covers key topics such as foot hygiene, daily foot inspection, proper nail and skin care, appropriate footwear selection, glycemic control, and early identification of complications. Educational strategies include lectures, demonstrations, printed materials, and interactive discussions to enhance participants' knowledge, self-efficacy, and adherence to recommended foot care behaviors.

Primary outcomes

  1. Pain Intensity Measured Using the Numeric Rating Scale (NRS)

    Time frame: Baseline and post-intervention (4-8 weeks).

    Change in pain intensity measured using the Numeric Rating Scale (NRS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain. Higher scores indicate greater pain intensity.

Secondary outcomes

  1. Diabetes Self-Efficacy Measured Using the Diabetes Self-Efficacy Scale (DSES)

    Time frame: Baseline and post-intervention (4-8 weeks).

    Change in diabetes self-efficacy measured using the Diabetes Self-Efficacy Scale (DSES). The scale consists of 8 items assessing patients' confidence in managing diabetes-related self-care behaviors. Each item is rated on a 5-point Likert scale ranging from 1 (not at all confident) to 5 (very confident). Total scores range from 8 to 40, with higher scores indicating higher self-efficacy.

Other outcomes

  1. Foot Self-Care Behaviors Measured Using the Diabetic Foot Self-Care Questionnaire (DFSQ-UMA-En)

    Time frame: Baseline and post-intervention (4-8 weeks).

    Change in foot self-care behaviors measured using the Diabetic Foot Self-Care Questionnaire (DFSQ-UMA-En). The instrument is a validated 16-item self-report questionnaire developed to assess self-care behaviors among patients with diabetes. It includes three domains: foot self-care, self-examination, and footwear/sock management. Items are rated on a Likert scale, and higher scores indicate poorer foot self-care behaviors.

  2. Health-Related Quality of Life Measured Using the EQ-5D-5L Questionnaire

    Time frame: Baseline and post-intervention (4-8 weeks).

    Change in health-related quality of life measured using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire. The EQ-5D-5L includes five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, each rated on a 5-level scale ranging from no problems to extreme problems. The EQ-5D index score typically ranges from values below 0 (worse than death) to 1 (full health), where higher scores indicate better health-related quality of life. Additionally, overall health status is assessed using the EQ Visual Analog Scale (EQ-VAS), ranging from 0 (worst imaginable health) to 100 (best imaginable health).

Study contacts

Contact information is provided by the study sponsor or research team.

Jawad AHMAD ABU-SHENNAR, Asst.Prof.Dr

CONTACT

[email protected]

+962779084560

Sponsors and collaborators

Lead sponsor

Jerash Private University

Other

Registry information

Official study title

Effectiveness of a Structured Educational Program on Pain Intensity, Self-Efficacy, Foot Self-Care Behaviors, and Health-Related Quality of Life Among Adults With Diabetic Foot: A Randomized Controlled Trial

Acronym: DF-EDU-RCT

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
May 4, 2026
Registry last updated
May 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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