Mohd Hanafi Azman Ong

A self-efficacy education programme on foot self-care behaviour among older patients with diabetes in a public long-term care institution, Malaysia: a Quasi-experimental Pilot Study

Objective A pilot self-efficacy education programme was conducted to assess the feasibility, acceptability and potential impact of the self-efficacy education programme on improving foot self-care behaviour among older patients with diabetes in a public long-term care institution. Method A prequasi-experimental and postquasi-experimental study was conducted in a public long-term care institution in Selangor, Malaysia. Patients with diabetes aged 60 years and above who fulfilled the selection criteria were invited to participate in this programme. Four self-efficacy information sources; performance accomplishments, vicarious experience, verbal persuasion and physiological information were translated into programme interventions. The programme consisted of four visits over a 12-week period. The first visit included screening and baseline assessment and the second visit involved 30u2009min of group seminar presentation. The third and fourth visits entailed a 20-min one-to-one follow-up discussion and evaluation. A series of visits to the respondents was conducted throughout the programme. The primary outcome was foot self-care behaviour. Foot self-efficacy (efficacy-expectation), foot care outcome expectation, knowledge of foot care, quality of life, fasting blood glucose and foot condition were secondary outcomes. Data were analysed with descriptive and inferential statistics (McNemars test and Wilcoxon signed-rank test) using the Statistical Package for the Social Sciences V.20.0. Results Fifty-two residents were recruited but only 31 met the inclusion criteria and were included in the analysis at baseline and at 12 weeks postintervention. The acceptability rate was moderately high. At postintervention, foot self-care behaviour (p<0.001), foot self-efficacy (efficacy-expectation), (p<0.001), foot care outcome expectation (p<0.001), knowledge of foot care (p<0.001), quality of life (physical symptoms) (p=0.003), fasting blood glucose (p=0.010), foot hygiene (p=0.030) and anhydrosis (p=0.020) showed significant improvements. Conclusion Findings from this pilot study would facilitate the planning of a larger study among the older population with diabetes living in long-term care institutions. Trial registration number ACTRN12616000210471; Pre-results.

The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia

Background Self-care behaviour is essential in preventing diabetes foot problems. This study aimed to evaluate the effectiveness of health education programs based on the self-efficacy theory on foot self-care behaviour for older adults with diabetes. Methods A randomised controlled trial was conducted for 12 weeks among older adults with diabetes in elderly care facility in Peninsular Malaysia. Six elderly care facility were randomly allocated by an independent person into two groups (intervention and control). The intervention group (three elderly care facility) received a health education program on foot self-care behaviour while the control group (three elderly care facility) received standard care. Participants were assessed at baseline, and at week-4 and week-12 follow-ups. The primary outcome was foot-self-care behaviour. Foot care self-efficacy (efficacy expectation), foot care outcome expectation, knowledge of foot care and quality of life were the secondary outcomes. Data were analysed with Mixed Design Analysis of Variance using the Statistical Package for the Social Sciences version 22.0. Results 184 respondents were recruited but only 76 met the selection criteria and were included in the analysis. Foot self-care behaviour, foot care self-efficacy (efficacy expectation), foot care outcome expectation and knowledge of foot care improved in the intervention group compared to the control group (p < 0.05). However, some of these improvements did not significantly differ compared to the control group for QoL physical symptoms and QoL psychosocial functioning (p > 0.05). Conclusion The self-efficacy enhancing program improved foot self-care behaviour with respect to the delivered program. It is expected that in the future, the self-efficacy theory can be incorporated into diabetes education to enhance foot self-care behaviour for elderly with diabetes living in other institutional care facilities. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12616000210471

The Mediating Impact of Beliefs on the Relationship between Values and Perception in Event Greening

The issue of sustainability is a global concern. There is a lack of knowledge about the perception towards the green concept and going green in Malaysia especially in the event management field of study. This study investigates the effect of values, beliefs and norms towards the perception of sustainable efforts towards event greening from event attendees’ point of view in the event management context. The objectives of this study are to determine the level of values, beliefs and norms that affect the perception of sustainable efforts towards event greening; to establish that event attendees’ values influence their perception on sustainable efforts towards event greening; to measure the mediation effect of beliefs in the relationship between values and perception on sustainable efforts towards event greening; to measure the mediation effect of norms in the relationship between values and perception on sustainable efforts towards event greening; to identify that cost is a concern to implement sustainable efforts towards event greening and to identify the reasons that event organizers are not keen to implement sustainable efforts towards event greening. Building from the perspective of event management, Value-Belief-Norm Theory, Theory of Planned Behaviour and Reflexive Theory of Perception; a conceptual model is developed and the hypotheses are drawn to show the interrelationship between these constructs. The partial least square (PLS) statistical approach has been conducted to test the research hypotheses. The analysis indicated that, there is a full mediating effect of Beliefs and Norms towards the relationship between Values and Perception.