The Effect of Empowerment Strategy for the Prevention of Diabetic Foot Ulcer and Amputation on Patients with History of Diabetic Foot Ulcer

  • Chin, Yen-Fan (PI)
  • Hsu, Brend Ray-Sea (CoPI)
  • Huang, Tzu-Ting (CoPI)

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details


The recurrent rate of diabetic foot ulcer (DFU) is above 40% within a year. Among patients with DFU recurrence, the amputation rate is 13 times of the rate among those with first DFU. However, there was no educational intervention preventing the DFU recurrence and subsequent amputation effectively. The empowerment strategies facilitate the diabetic self-management of patients. The transtheoretical model (TTM) based intervention have an effect on the modification of DFU risk factors. Thus, the empowerment strategies based on TTM stage may be helpful to decrease the DFU recurrence and subsequent amputation. This is a three-year proposal. The purposes of this study are (1) to evaluate the effect of a empowerment strategy on decreasing DFU recurrence and subsequent amputation, and (2) to develop and test the diabetes foot ulcer self-care knowledge scale, the diabetes foot ulcer self-care behavior scale, and the diabetes foot ulcer management self-efficacy scale. In the first year, two hundred and forty outpatients with DFU history will be recruited from one medical center and one teaching hospital in the northern part of Taiwan. They will be interviewed and their foot will be assessed. The baseline data will be used for developing and testing the psychometric characteristic of the above three scales. Then subjects will be randomized to either the control group or the experimental group. In the experimental group, empowerment-based strategies will be provided individually based on the TTM stages of subjects for modifying their risk factors of DFU, and improving their foot self-care behaviors. Subsequent follow-up evaluations will be delivered at the second, third and subsequent every three months. The foot self-care behaviors, DFU management self-efficacy, the recurrence of DFU and subsequent amputation will be evaluated. In the second and third years, the subsequent education and evaluation will be delivered every three months. The survival analysis will be used to analysis the effect of intervention on the recurrence of DFU and subsequent amputation with the risk factors, and demographic variables being controlled. The foot self-care behaviors and DFU management self-efficacy data will be analyzed by the generalized estimating equation. In the first year, the above three scales will be developed. They can be used by clinicians and researchers to evaluate the patients’ DFU self-care behavior, knowledge, and self-efficacy. In the second and third year, the mid-term and long-term effect of the empowerment intervention will be evaluated. Results of this study can be used by healthcare personnel to provide effective interventions for preventing the DFU recurrent and subsequent amputation.

Project IDs

Project ID:PC10408-1526
External Project ID:MOST104-2314-B182-003
Effective start/end date01/08/1531/07/16


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