Stepping forward: A study protocol for developing and validating a Malaysian diabetic foot self-care practice...

Area of Science:

• Endocrinology
• Public Health
• Health Services Research

Background:

• Diabetic foot ulcers present a significant global health and economic challenge.
• Effective management hinges on patient self-care, often compromised by painless neuropathy.
• Current lack of a standardized assessment tool hinders nationwide evaluation of diabetic foot self-care in Malaysia.

Purpose of the Study:

• To develop and validate a culturally relevant instrument for assessing diabetic foot self-care practices in Malaysia.
• To create a tool with simple scoring for daily clinical use.
• To establish a benchmark for evaluating and improving diabetic foot care nationwide.

Main Methods:

• A two-phase approach: instrument development (literature review, item generation, expert validation, translation, pre-testing, stakeholder engagement) and validation (cross-sectional study with pilot and field testing).
• Inclusion of diverse perspectives from experts and local patients ensures contextual relevance and comprehensibility.
• Validation will involve establishing cut-off ranges and interpretations across urban and rural Malaysian public health clinics.

Main Results:

• The methodology outlines a comprehensive process for creating a culturally adapted and validated instrument.
• Expert reviews and patient pre-tests will refine the tool for clarity and relevance.
• The validation phase will provide empirical data on the instrument's reliability and utility.

Conclusions:

• A validated instrument is essential for identifying service provision gaps in diabetic foot self-care.
• Targeted interventions and individually tailored education can be implemented based on assessment findings.
• The instrument will enable longitudinal monitoring of patient self-care practice improvements, crucial for preventing diabetic foot ulcers.