Effect of health education on foot care knowledge and practice of patients with type 2 diabetes in rural Bangladesh

Diabetic foot complications represent one of the most severe consequences of diabetes mellitus, with substantial global prevalence of diabetic foot ulcers. In Bangladesh, a significant proportion of type 2 diabetes patients are at risk of diabetic foot ulcers, yet patients’ foot care knowledge and practice remain largely unsatisfactory. This study aimed to explore the effectiveness of a foot care education session among rural diabetic patients in Bangladesh. A single-group pre-post study design was employed to develop and apply a footcare education module among 51 patients with type 2 diabetes mellitus at Shailkupa Diabetic Hospital, Jhenaidah, Bangladesh, from August to December 2023. It included two sessions involving a slide presentation with video demonstrations, and hands-on practice with take-home booklets. Evaluation of the knowledge and practice score was done before and four weeks after the intervention. Knowledge was assessed using a validated 15-item questionnaire, while practice was evaluated using the 29-item Nottingham Assessment of Functional Foot Care (NAFF). Participants had a mean age of 52 (± 12) years (± SD), with 64.7% female and 76.5% experiencing diabetic foot-related problems. The educational intervention resulted in significant short-term improvements in both knowledge and practice scores (p < 0.001). Multiple linear regression analysis identified pre-intervention knowledge score (0.91 [β], 0.78 to 1.0 [95%CI]) as the most significant determinant of post-intervention knowledge score. The factors associated with post-intervention practice scores were pre-intervention practice scores (0.91, 0.74 to 1.1), and change in knowledge score (2.0, 0.95 to 3.0). Structured foot care education can be incorporated to improve diabetic foot care in routine diabetes management in resource-limited primary healthcare settings.