# APBA Kısa Özet

This systematic review synthesizes findings from nine quasi-experimental studies published between 2015 and 2024 to evaluate the effectiveness of educational programmes on nurses' knowledge and practice regarding diabetic foot care. The analysis reveals that educational interventions are consistently associated with improvements in both knowledge and clinical practice. However, the overall certainty of evidence was rated as very low using the GRADE approach, primarily due to methodological limitations, heterogeneity in intervention content and duration, and inconsistent outcome measurement tools. These results suggest that while educational programmes hold promise for improving diabetic foot care competencies, current evidence should be interpreted with caution.

# Çalışma neyi araştırdı?

The review aimed to determine the effectiveness of educational programmes in improving nurses' knowledge and clinical practice related to diabetic foot care. By synthesizing data from quasi-experimental studies, the authors sought to understand how various educational strategies influence nurse competencies in managing diabetic foot health.

# Yöntem

Researchers conducted a systematic search of quasi-experimental studies published between 2015 and 2024 across five major databases: Web of Science, Cochrane Library, CINAHL, MEDLINE, and Scopus. The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies was utilized to assess the methodological quality of the included studies. Given the significant variability in study designs, intervention content, and outcome measures, the results were summarized narratively; a meta-analysis was not performed. The GRADE approach was employed to assess the certainty of evidence for both knowledge and practice outcomes.

# Temel bulgular

  • Nine included studies consistently reported positive effects of educational interventions on nurses' knowledge and/or clinical practice concerning diabetic foot care.
  • Interactive and practical educational formats, such as workshops and simulation-based training, appeared particularly promising in improving diabetic foot care competencies compared to traditional lecture-based approaches.
  • Significant heterogeneity was observed in intervention content, duration, follow-up periods, and the tools used to measure outcomes (e.g., self-reported questionnaires, validated tests, and direct observation).
  • The GRADE assessment classified the certainty of evidence for both knowledge and practice outcomes as "very low."

# Bulgular ne anlama geliyor?

Educational programmes represent a potential tool for enhancing nurses' knowledge and practice skills in diabetic foot care. The findings suggest that interactive, practical, and hands-on educational approaches are more likely to yield measurable improvements. However, because the included studies are predominantly quasi-experimental, lack randomization, and utilize non-standardized outcome measures, the generalizability of these findings is limited. Consequently, while the results are suggestive and directionally informative, the effectiveness of these programmes cannot be considered definitively proven based on the current evidence base.

# Klinik Önemi

Improving nurses' knowledge and practical skills in diabetic foot care is crucial for reducing the risk of foot ulcers and lower-limb amputations. Integrating educational programmes into routine clinical training curricula—particularly those incorporating interactive and practical components—holds potential for improving the quality of foot care services. Nevertheless, clinical decisions based on these findings should be approached with caution until higher-quality evidence, such as well-designed randomized controlled trials, becomes available.

# Sınırlılıklar

  • All included studies were quasi-experimental in design, lacking randomization and blinding, which limits internal validity and the ability to establish causal relationships.
  • Considerable heterogeneity existed across studies regarding intervention content, duration, educational materials, and follow-up durations, hindering direct comparisons.
  • Outcome measures were not standardized; studies utilized various instruments (surveys, tests, observations), making synthesis and generalization difficult.
  • No included studies evaluated patient-level clinical outcomes such as ulcer development or amputation rates; the focus remained solely on nurse knowledge and behavior.
  • The limited number of included studies and the potential for publication bias further reduce the overall reliability and generalizability of the review findings.