Effects of health education on the prevention of diabetic foot: systematic review with meta-analysis

The diabetic foot represents a clinical problem with repercussions on the quality of life but also an economic one. Self-care of the feet can prevent ulcers and consequently amputations in diabetic people. Aim: To evaluate the effects of health education actions in the foot care of people with diabetes. Methods: A systematic review with meta-analysis was performed. The descriptors used were “Nursing,” “Self-care,” “Disease Prevention,” and “Diabetic Foot,” associated with the Boolean operators AND and OR. The final data collection resulted in ten articles. The following methods of analysis were used: Forest plot and funnel chart, covariance ratio, Cook’s distance, Baujat, GOSH analysis, and Egger’s test. Results: The compiled analysis of the outcomes for behavior shows that the Standard Mean Difference (SMD) between groups increased from -1.56 (-4.0; 0.9) in the first evaluation to 14.1 (9.3; 18.9) in the final evaluation; for knowledge, it increased from -0.2 (-0.6; 0.2) in the first evaluation to 2.4 (1.2; 3.7) in the final evaluation; for self-efficacy, it increased from 0.6 (-1.1; 2.3) in the first evaluation to 9.6 (7.2; 12) in the final evaluation. Conclusion: The meta-analysis allowed us to conclude that there was effects for the knowledge, behavior and self-efficacy of health education actions in foot care in people with diabetes.