Journal of Education and Health Promotion

Investigating the effect of educational intervention based on the Pender’s health promotion model on lifestyle and self‑efficacy of the patients with diabetic foot ulcer: A clinical trial

Document Type : Original Article

Authors

. Parya Vakilian
. Mokhtar Mahmoudi 1
. Fatemeh Oskouie 2
. Ali Asghar Firouzian 3
. Alice Khachian 2

1 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran,

2 Department of Medical Surgical Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

3 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Esfarayen University of Medical Sciences, Esfarayen, Iran

Abstract
BACKGROUND: This study aimed to investigate the effect of educational intervention based on the
Pender’s health promotion model (HPM) on lifestyle and self‑efficacy of the patients with diabetic
foot ulcer.
MATERIALS AND METHODS: In this clinical trial conducted in 2019, 74 patients based on
inclusion criteria were selected through convenience sampling and allocated to two groups of
intervention (n = 37) and control (n = 37) using the randomized permuted block method. In this
study, Demographic characteristics and localized Diabetes Foot Care Self‑Efficacy Scale and
Health‑Promoting Lifestyle Profile Questionnaire for diabetic foot care were completed by two groups.
The obtained data were analyzed using SPSS 16 and through descriptive and comparative statistics,
independent t‑test, paired t‑test, and ANCOVA.
RESULTS: After the intervention, the mean score of the intervention group significantly increased
in all lifestyle dimensions (P < 0.001). Furthermore, the mean score of self‑effcacy increased in the
intervention group after the intervention (P < 0.001). Comparing the change in the mean scores of
lifestyle and self‑efficacy in both the groups 50 days after the intervention, an increase was observed
in the mean scores of self‑efficacy (P < 0.001) as well as those of lifestyle and its dimensions in the
intervention group compared to those in the control group (P < 0.001).
CONCLUSION: Educational intervention based on the Pender’s HPM can promote the self‑efficacy,
lifestyle, and its dimensions in the patients with diabetic foot ulcers. The results of this study can be
used in educational interventions aiming at patients with diabetic foot ulcers to change their lifestyle
and improve their self‑efficacy.


Keywords

Diabetic foot
health promotion
lifestyle
self‑efficacy
  1. Biçer E, Enç N. Evaluation of foot care and self‑efficacy in patients
    with diabetes in Turkey: An interventional study. Int J Diabetes
    Dev Ctries 2016;36:334‑44.
    2. WHO [Internet] Global Report On Diabetes in Switzerland
    2016. Available from: https://apps.who.int/iris/bitstream/
    handle/10665/204871/9789241565257_eng.pdf;jsessionid=DDC7
    E2C6349CB014954A06CD1A6B4520?sequence=1 . [Last updated
    on 2016May 20; Last cited on 2016 Aug 10].
    3. Fujiwara Y, Kishida K, Terao M, Takahara M, Matsuhisa M,
    Funahashi T, et al. Beneficial effects of foot care nursing for
    people with diabetes mellitus: An uncontrolled before and after
    intervention study. J Adv Nurs 2011;67:1952‑62.
    4. Fan L, Sidani S, Cooper‑Brathwaite A, Metcalfe K. Improving foot
    self‑care knowledge, self‑efficacy, and behaviors in patients with
    type 2 diabetes at low risk for foot ulceration: A pilot study. Clin
    Nurs Res 2014;23:627‑43.
    5. HuangYY, Lin KD, JiangYD, Chang CH, Chung CH, Chuang LM,
    et al. Diabetes‑related kidney, eye, and foot disease in Taiwan:
    An analysis of the nationwide data for 2000‑2009. J Formos Med
    Assoc 2012;111:637‑44.
    6. Mashaikhi M, Larijani B, Mohajerani M. Investigation of frequency
    of amputations in patients with diabetic foot ulcers hospitalized
    in Shariati Hospital. Iran J Diabetes Lipid Disord 2014;12:543‑59.
    7. Keegan J, Chan F, Ditchman N, Chiu C. Predictive ability of
    Pender’s health promotion model for physical activity and
    exercise in people with spinal cord injuries. Rehabil Couns Bull
    2012;56:34‑47.
    8. Wellard SJ, Rennie S, King R. Perceptions of people with type 2
    diabetes about self‑management and the efficacy of community
    based services. Contemp Nurse 2008;29:218‑26.
    9. Mohebi S, Azadbakht L, Feizi A, Sharifirad G, Kargar M. Review
    the key role of self‑efficacy in diabetes care. J Educ Health Promot
    2013;2:36.
    10. Penwell‑Waines L, Lewis K, Valvano A, Smith S, Rahn R,
    Stepleman L. Testing the health promotion model for adherence
    and quality of life in individuals with multiple sclerosis. Psychol
    Health Med 2017;22:205‑11.
    11. Teymouri P, Niknami S, Ghofranipour F. Effects of a school‑based
    intervention on the basis of Pender’s health promotion model to
    improve physical activity among high school girls. Armaghan
    Danesh Mag 2007;12:48‑52.
    12. Radmehr M, Ashktorab T, Neisi L. Effect of the educational
    program based on Pender’s theory on the health promotion in
    patients with obsessive – Compulsive disorder. Nurs Educ Mag
    2013;2:56‑63.
    13. Shahsavari S, Peyrove H. Nursing Theories and Their Application.
    Iran University of Medical Sciences: Hakim Publications Hydjy;
    2011. p. 210‑5.
    14. BakerMK, SimpsonK, LloydB, BaumanAE, SinghMA. Behavioral
    strategies in diabetes prevention programs: A systematic review of
    randomized controlled trials. Diabetes Res Clin Pract 2011;91:1‑2.
    15. Lin CC, Li CI, Liu CS, Lin WY, Fuh MM, Yang SY, et al. Impact of
    lifestyle‑related factors on all‑cause and cause‑specific mortality
    in patients with type 2 diabetes: The Taichung diabetes study.
    Diabetes Care 2012;35:105‑12.
    16. Radmehr M, Ashktora T, Neisi L. Effectiveness of educational
    programs based on Pender’s theory on the health and symptoms
    in patients with obsessive‑compulsive disorder. Life Sci J
    2012;9:2174‑80.
    17. Safabakhsh L, Moatary M. Examination of education protocol
    based on pender theory on lifestyle of patients after bypass
    cronery. In: Master’s Thesis Nursing. Shiraz Science of Medicine
    University; 2004.
    18. Shi Q, Ostwald SK, Wang S. Improving glycaemic control
    self‑efficacy and glycaemic control behaviour in Chinese patients
    with type 2 diabetes mellitus: Randomised controlled trial. J Clin
    Nurs 2010;19:398‑404.
    19. Bentsen SB, Wentzel‑Larsen T, Henriksen AH, Rokne B, Wahl AK.
    Self‑efficacy as a predictor of improvement in health status and
    overall quality of life in pulmonary rehabilitation – An exploratory
    study. Patient Educ Couns 2010;81:5‑13.
    20. Mohamadinejad F, Pedram Razi S, Aliasgharpour M, Tabari F,
    KazemnejadA. Effect of patient education program on self‑efficacy
    in patients with diabetes. Iran J Nurs Res 2014;10:35‑41.
    21. Hajizadeh E, Asghari M. Statistical Methods and Analysis Looking
    At Research Methods in Biological and Health Sciences. Tabriz
    University of Medical Sciences Publications Organization; 2011.
    22. Walker S, Hill‑Polerecky DM. Psychometric Evaluation of The
    Health Promoting Lifestyle Profile Ii. Omaha, NE: University of
    Nebraska; 1996.
    23. Mohammadi Zeidi I, Pakpour Haji Agha A, Mohammad Zeidi B.
    Validity and reliability of the Persian version of health
    promoting lifestyle questionnaire. J Mazandaran Univ Med Sci
    2011;21:103‑13.
    24. Zhang JE, Wong FK, You LM, Zheng MC. A qualitative study
    exploring the nurse telephone follow‑up of patients returning
    home with a colostomy. J Clin Nurs 2012;21:1407‑15.
    25. Sen E, Sirin A. Healthy lifestyle behaviors and self‑efficacy: The
    effect of education. The Anthropologist 2015;21:89‑97.
    26. Carreño J, Vyhmeister G, Grau L, Ivanovic D. A health promotion
    programme in Adventist and non‑Adventist women based on
    Pender’s model: A pilot study. Public Health 2006;120:346‑55.
    27. Shin KR, Kang Y, Park HJ, Cho MO, Heitkemper M. Testing and
    developing the health promotion model in low‑income, Korean
    elderly women. Nurs Sci Q 2008;21:173‑8.
    28. HoAY, Berggren I, Dahlborg‑LyckhageE. Diabetes empowerment
    related to Pender’s Health Promotion Model: A meta‑synthesis.
    Nurs Health Sci 2010;12:259‑67.
    29. Mohammadipour F, Izadi Tameh A, Sepahvand F, Naderifar M.
    The impact of an educational intervention based on Pender’s
    health promotion model on the lifestyle of patients with type II
    diabetes. J Diabetes Nurs 2015; 10;2 (4):25‑35.
    30. Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of
    Pender’s health promotion model in improving the nutritional
    behavior of overweight and obese women. Int J Community Based
    Nurs Midwifery 2017;5:165‑74.
    31. Hosseini M, Ashktorab T, Taghdisi M. Health promotion lifestyle
    in nursing students: A systematic review. J Health Promot Manag
    2013;2:66‑79.
    32. Mohseni PouyaH, MajlessiF, ShojaeizadehD, Rahimi ForooshaniA.
    The effect of educational intervention based on the Pender’s health
    promotion model on patients’ self‑efficacy for self‑care behaviors
    following heart surgery. Iran J Nurs Res 2017;12:16‑23.
  2. 33. MohamadianH, EftekharH, RahimiA, MohamadHT, ShojaiezadeD,
    Montazeri A. Predicting health‑related quality of life by using a
    health promotion model among Iranian adolescent girls: Astructural
    equation modeling approach. Nurs Health Sci 2011;13:141‑8.
    34. Mohammadi Zeidi I, Ziaeiha M, Safari Variyani A, Khalaj M,
    Mohammadi Zeidi B, Morshedi H. Predicting the stages of change
    in physical activity behavior of QUMS students with Pender’s
    model. J Qazvin Univ Med Sci 2010;14:58‑66.
    35. Homko CJ, Sivan E, Reece EA. The impact of self‑monitoring
    of blood glucose on self‑efficacy and pregnancy outcomes in
    women with diet‑controlled gestational diabetes. Diabetes Educ
    2002;28:435‑43.
Journal of Education and Health Promotion
Volume 11, Issue 11
December 2021
Pages 1-9

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us