Prevention and Management of Diabetes-Related Foot Ulcers through Informal Caregiver Involvement: A Systematic Review

Table 3

Diabetes-related foot ulcer prevention outcomes.

Outcomes	How outcome was measured	Results	Certainty of the evidence	Study IDs
(i) Foot care behavior/practices of participants	(i) DFCS (Liang et al.); (ii) SDSCA (Keogh et. al.; Maslakpak et al.; McEwen et al.; (iii) SKILLD (William et al.); (iv) Revised SDSCA (Hu et al.); (v) DFSCBS (Li et al.)	Seven studies reported on the foot care behavior of participants. Six out of the seven studies recorded an improvement in foot self-care practices of participants at postintervention, and the difference with baseline scores in each study was significant.	⨁⨁⨁◯; Moderate	(i) Liang (2012); (ii) Keogh (2012); (iii) Maslakpak (2017); (iv) McEwen (2017); (v) Hu (2014); (vi) William (2014); (vii) Li (2019)
(i) Diabetes knowledge	(i) DKQ (Liang et al.); (ii) SKILLD (Hu et al.; Williams et al.)	Two studies had data on this outcome, and each of them indicated that knowledge on diabetes increased significantly in the intervention groups and was sustained at 1 year and 2 years follow-ups	⨁⨁⨁⨁; High	(i) Liang (2012); (ii) Hu (2014); (iii) William (2014)
(i) HbA1c	(i) DAC machine (McEwen et al.); (ii) Bayer A1C NOW kit (Hu et al.); (iii) Laboratory values used by all other studies	Nine studies contributed data to this outcome. All nine studies reporting the levels of HbA1c indicated that there was improvement in the level of HbA1c at postintervention. However, two out of the nine studies indicated that though there was improvement in the intervention group, the difference was not significant when compared with the baseline values	⨁⨁⨁◯; MODERATE	(i) Liang et al. (2012); (ii) Subrata et al. (2020); (iii) McEwen et al. (2017); (iv) Maslakpak et al. (2017); (v) Keogh et al. (2011); (vi) Hu et al. (2014); (vii) William et al. (2014); (viii) Viswanathan et al. (2005); (ix) Appil et al. (2020)

Key: DFSCBS: Diabetes Foot Self-care Behaviour Scale; SDSCA: Summary of Diabetes Self-care Activities scale; DFUAS: Diabetes Foot Ulcer Assessment Scale; PEDIS: Perfusion, Extent, Depth, Infection and Sensation; SKILLD: Spoken Knowledge in Low Literacy patients with Diabetes; DKQ: Diabetes Knowledge Questionnaire; DFCS: Diabetes Foot Care Scale.