Mohammad Al-Me'ani, Omar Alqaisi, Mohammed Dibas, Heyam Al-Aaraj, Yousef Rubbai
Educational programmes were consistently associated with improvements in nurses' knowledge and practice regarding diabetic foot care. The findings suggest that healthcare training could be integrated with ongoing professional development programmes, emphasizing experiential learning. However, the very low certainty of evidence and predominance of non-randomized quasi-experimental designs limit causal inference. More rigorous randomized or cluster-randomized studies with standardized outcome measures, longer follow-up and patient-level outcomes are needed.
BACKGROUND: Diabetes mellitus is a leading global non-communicable disease associated with significant morbidity, mortality and healthcare burden. Diabetic foot complications represent a leading cause of hospitalization and lower-limb amputation in this population.
OBJECTIVE: To systematically evaluate the effects of educational programmes on nurses' knowledge and practice regarding diabetic foot care.
METHODS: A systematic search of quasi-experimental studies from 2015 to 2024 was performed. Web of Science, Cochrane Library, CINAHL, MEDLINE and Scopus databases were searched using a comprehensive search strategy. The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies was used to evaluate methodological quality. The results were summarized narratively due to variations in study designs, interventions and outcome measures. The GRADE approach was used for assessment of the evidence certainty.
RESULTS: A total of nine studies met the inclusion criteria. Educational interventions were found to be consistently linked to enhanced knowledge and/or clinical practice concerning diabetic foot care among nurses in the included studies. Interactive and practical educational approaches appeared particularly promising; however, considerable heterogeneity existed in intervention content, duration, measurement instruments and follow-up periods. The overall certainty of evidence for both knowledge and practice outcomes was rated as very low.
CONCLUSION: Educational programmes were consistently associated with improvements in nurses' knowledge and practice regarding diabetic foot care. The findings suggest that healthcare training could be integrated with ongoing professional development programmes, emphasizing experiential learning. However, the very low certainty of evidence and predominance of non-randomized quasi-experimental designs limit causal inference. More rigorous randomized or cluster-randomized studies with standardized outcome measures, longer follow-up and patient-level outcomes are needed.
TRIAL REGISTRATION: PROSPERO: CRD420261404535.