Conclusion
To strengthen the findings and to show an enhanced selfefficacy
in the long term, a larger well-powered study
should be conducted. As this study collected only selfreported
outcomes a longitudinal study could additionally
report outcomes such as ulceration or amputation
rates. If the results are proofed relevant the programme
should be made available as parts of routine diabetes
care for high-risk patients, as preventive foot care is an
important issue in this population.
This study showed that nurses successfully administer
interventions aimed at enhancing self-efficacy in highrisk
patients with diabetes. Therefore, it is vital that diabetes
nurses take a supporting and facilitating role.20 In
addition to learning new practical skills, patients have
to cope with life-long diseases and may need help in
accepting the changes which are occurring in their
lives.21 By incorporating such interventions into existing
disease – management programmes, in which diabetes
nurses already play a large role, quality of care may be
enhanced.