Diabetes Mellitus, Type 2, Neuropathy;Peripheral
Conditions
Keywords
patient education
Brief summary
Traditional directive style of requesting or demanding compliance to set behavior is found to have little effect on patient's self-care behavior. It is reported that patients prefer to restate or rephrase their understanding in a care setting, instead of a directive/didactic approach where the clinician provides 'one-way' information. In fact, directive persuasion is thought to lead to resistance to change and is counter-effective. New approaches such as open ended communication, interview style and collaborative approach is found to engage patients better in their own care and elicit patient's own intrinsic motivations for making changes. One way to do this is to 1. invite patient to share their thoughts or concerns then 2. clarify patient's understanding From their responses: (3a) affirm patient's correct understanding or (3b) address misconceptions with permission. In this study, the investigators will randomize 240 subjects into two groups: Group A will undergo the above describe collaborative approach to patient education and counselling; Group B will undergo current (traditional, didactic approach) patient education. It is hypothesized that the collaborative approach group (Group A) should experience better understand of their health condition and foot ulcer, be better able to adhere to treatment plan through collaborative participation and overall be more satisfied with the treatment. Outcomes will be tracked at (i) post intervention and (ii) 4 months post intervention.
Interventions
Using a collaborative approach to engage patients in their own care, allowing patients to continue to have full control of their treatment. The clinician and patient co-creates the treatment plan.
Sponsors
Study design
Intervention model description
Suitable participants recruited and randomised into Study Intervention Group or Control Group.
Eligibility
Inclusion criteria
1. Diagnosed type II diabetes 2. Above age 21 3. Plantar foot ulcer - high risk with active full-thickness ulcer 4. Pedal pulses palpable or min toe pressure of 30mmHg 5. Medium of language: English 6. Activities of daily living (ADL) independent (without carer)
Exclusion criteria
1. Diagnosed mental health conditions 2. Diagnosed cognitive impairment 3. Diagnosed visual impairment 4. Diagnosed hearing and speech disabilities
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wound healing | 12 weeks | Percentage patients with healed wound (wound size = 0cm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knowledge score assessed by questionnaire | Week 1 and week 12 | Knowledge score in Knowledge & Behaviour questionnaire (Maximum score 16) |
| Behaviour score assessed by questionnaire | Week 1 and week 12 | Behaviour score in Knowledge & Behaviour questionnaire (Maximum score 59) |
Countries
Singapore