Abstract
Purpose: Diabetic foot ulcers (DFU) lead to serious health complications, including a 65% recurrence rate within 3 to 5 years, a 20% chance of amputations, and up to a 70% mortality rate over five years1,2. Furthermore, recent studies indicate that the overall incidence of amputation has increased1. These trends underscore the urgent need for effective DFU prevention strategies3,4. This pilot study investigated digital storytelling videos as a tool5 to empower adults with type 2 diabetes to enhance foot care knowledge and practices.
Methods: Participants were recruited from a primary care group by a nurse practitioner (April-July 2024). Over a six-week period, each participant received a weekly 5-minute digital storytelling video, developed by an interdisciplinary team of physicians, nurses, and a psychologist. The videos were based on real-life scenarios and covered key foot care topics. Diabetes foot care knowledge was evaluated using scores from pre- and post-video items designed for this study. Foot care behaviors were measured using the Summary of Diabetes Self-Care Activities (SDSCA) foot scale6 at baseline (alpha=0.79), 6-week post-program (alpha=0.87), and 12-week follow-up (alpha=0.90). To evaluate this single group design, pair t-tests and a one-way repeated measures ANOVA were conducted.
Results: Twenty-six patients completed the program (Mean age=53.13, SD=4.64 years; 58% female; 30% Black, 23% Hispanic, 19% Asian; 42% college degree or more; 62% married). There was a significant increase in the foot care knowledge scores before and after each of the six videos [video 1: t(25) = -2.91, p< 0.01; video 2: t(25) = -6.39, p< 0.001; video 3: t(25) = -5.13, p< 0.001; video 4: t(25) = -4.08, p< 0.001; video 5: t(25) = -2.31, p< 0.05; video 6: t(25) = -3.76, p< 0.001]. A one-way repeated measures ANOVA revealed that there was a positive difference in foot care practices over time [F (2,50) = 8.04, p< 0.001].
Conclusion: A digital storytelling video program designed to enhance diabetes foot care resulted in a significant improvement in foot care knowledge and behaviors among adults with type 2 diabetes. The promising results from this study highlight the potential and feasibility of integrating digital storytelling videos into patient education for adults with type 2 diabetes. Further research is needed to evaluate the long-term sustainability of diabetes foot care knowledge and behaviors and their impact on health outcomes.
Notes
References:
1. McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care. Jan 1 2023;46(1):209-221. doi:10.2337/dci22-0043
2. Walicka M, Raczynska M, Marcinkowska K, et al. Amputations of lower limb in subjects with diabetes mellitus: reasons and 30-Day mortality. J Diabetes Res. 2021;2021:8866126. doi:10.1155/2021/8866126
3. Magliano DJ, Boyko EJ. IDF Diabetes Atlas. 10th ed. International Diabetes Federation; 2021. Accessed October 30, 2024. https://www.ncbi.nlm.nih.gov/books/NBK581934/
4. McPherson M, Carroll M, Stewart S. Patient-perceived and practitioner-perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review. J Foot Ankle Res. Dec 16 2022;15(1):92. doi:10.1186/s13047-022-00597-6
5. Lohr AM, Raygoza Tapia JP, Valdez ES, et al. The use of digital stories as a health promotion intervention: a scoping review. BMC Public Health. Jun 14 2022;22(1):1180. doi:10.1186/s12889-022-13595-x
6. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. Jul 2000;23(7):943-50. doi:10.2337/diacare.23.7.943
Sigma Membership
Zeta Pi
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Primary Care, Teaching and Learning Strategies, Virtual Learning, Digital Storytelling, Diabetic Foot Ulcers, DFU, Type 2 Diabetes, Adults, Foot Care
Recommended Citation
Ju, Hsiao-Hui; Alford, Jeffery; White, Dina; and Hernandez, Daphne, "Asynchronous Virtual Intervention for Diabetes Foot Care: A Storytelling and Empowerment Program" (2025). International Nursing Research Congress (INRC). 125.
https://www.sigmarepository.org/inrc/2025/presentations_2025/125
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Asynchronous Virtual Intervention for Diabetes Foot Care: A Storytelling and Empowerment Program
Seattle, Washington, USA
Purpose: Diabetic foot ulcers (DFU) lead to serious health complications, including a 65% recurrence rate within 3 to 5 years, a 20% chance of amputations, and up to a 70% mortality rate over five years1,2. Furthermore, recent studies indicate that the overall incidence of amputation has increased1. These trends underscore the urgent need for effective DFU prevention strategies3,4. This pilot study investigated digital storytelling videos as a tool5 to empower adults with type 2 diabetes to enhance foot care knowledge and practices.
Methods: Participants were recruited from a primary care group by a nurse practitioner (April-July 2024). Over a six-week period, each participant received a weekly 5-minute digital storytelling video, developed by an interdisciplinary team of physicians, nurses, and a psychologist. The videos were based on real-life scenarios and covered key foot care topics. Diabetes foot care knowledge was evaluated using scores from pre- and post-video items designed for this study. Foot care behaviors were measured using the Summary of Diabetes Self-Care Activities (SDSCA) foot scale6 at baseline (alpha=0.79), 6-week post-program (alpha=0.87), and 12-week follow-up (alpha=0.90). To evaluate this single group design, pair t-tests and a one-way repeated measures ANOVA were conducted.
Results: Twenty-six patients completed the program (Mean age=53.13, SD=4.64 years; 58% female; 30% Black, 23% Hispanic, 19% Asian; 42% college degree or more; 62% married). There was a significant increase in the foot care knowledge scores before and after each of the six videos [video 1: t(25) = -2.91, p< 0.01; video 2: t(25) = -6.39, p< 0.001; video 3: t(25) = -5.13, p< 0.001; video 4: t(25) = -4.08, p< 0.001; video 5: t(25) = -2.31, p< 0.05; video 6: t(25) = -3.76, p< 0.001]. A one-way repeated measures ANOVA revealed that there was a positive difference in foot care practices over time [F (2,50) = 8.04, p< 0.001].
Conclusion: A digital storytelling video program designed to enhance diabetes foot care resulted in a significant improvement in foot care knowledge and behaviors among adults with type 2 diabetes. The promising results from this study highlight the potential and feasibility of integrating digital storytelling videos into patient education for adults with type 2 diabetes. Further research is needed to evaluate the long-term sustainability of diabetes foot care knowledge and behaviors and their impact on health outcomes.
Description
Diabetic foot ulcers (DFU) can lead to serious health complications, highlighting the urgent need for effective prevention strategies in diabetes management. A digital storytelling video program designed to enhance diabetes foot care resulted in a significant improvement in foot care knowledge and behaviors among adults with type 2 diabetes.