Medium-term effectiveness of a group educational intervention on foot care in patients with type 2 diabetes

Aim. To evaluate the medium-term effectiveness of a group educational intervention in primary care aimed at improving attitudes and skills in self-care of the feet in patients with type 2 diabetes, and to determine the optimal time for reintervention. Method. We performed a before-after intervention study with a 24-month follow-up. The sample consisted of 76 patients with type 2 diabetes who underwent two group education sessions. Sociodemographic variables and variables related to the neurovascular status of the foot and with hygiene and self-care habits were measured. To compare the results, McNemar's test for paired data was used. Results. The mean age was 66 years and 51% were men. Skills performance before-after (8 months) the intervention were as follows: correct hygiene 41%-86%, good-medium hydration 80%-97%, daily foot washing 42%-68%, proper tools use 41%-79%, proper shoes 9%-33%, proper nails 26%-74% (all differences with p< 0.001). Among patients that improved due to the sessions, skills were still correct at 24 months in 76% (95% CI: 61%-90%) for hygiene, 100% for hydration, 70% for daily foot washing (95% CI: 51%-90%), 74% for proper tools use (95% CI: 58-90%), 55% for proper shoes (95% CI: 34%-77%) and 81% for proper nails (95% CI: 68%-94%). Conclusions. The intervention improved all the skills studied. The effects of the sessions were still evident after 24 months in more than 70% of patients for all the variables studied except proper shoe use. Group education favors skills improvement. We suggest repeating the intervention every 24 months.