The Effect of Diabetic Foot Training Given to Patients With Type-2 Diabetes Using Virtual Reality Glasses on Foot Care Behaviors

The Effect of Diabetic Foot Training Given to Patients With Type-2 Diabetes Using Virtual Reality Glasses on Foot Care Behaviors

Diabetes mellitus is a chronic disease characterized by high blood sugar resulting from insulin deficiency and/or ineffectiveness. Diabetes is increasingly recognized as a significant public health problem due to its increasing prevalence and potential for a wide range of complications. Diabetic foot, one of the most common complications of diabetes, has become a widespread problem in parallel with the rapidly increasing prevalence of diabetes both globally and domestically. Since healthcare expenditures for diabetic foot care account for one-third of total spending on diabetes treatment, the importance of planning patient education, implementing evidence-based preventive approaches, and regularly monitoring patients to prevent the development of diabetes and diabetic foot is evident. Furthermore, the adoption of evidence-based preventive approaches and regular patient follow-up are essential in this context. Diabetes education nurses, in particular, play a critical role in this regard. Today, with advancements in health technologies and diabetes treatments, significant breakthroughs and improvements in diabetes treatment and care are regularly occurring. Therefore, nurses should plan and implement training every six months or even annually to share current information with patients and facilitate their adaptation to new treatment approaches. The literature particularly emphasizes the importance of providing comprehensive education to individuals with diabetes on disease management, including diet, medication, exercise, and foot care. The need to address the specific needs of these patients for optimal care is also emphasized. Therefore, it is crucial to design and implement effective educational strategies that incorporate current technological applications to transform the knowledge and habits of individuals with diabetes into adaptive behaviors that can reduce the likelihood of developing diabetic foot ulcers. One such application, virtual reality headsets, provide an immersive, three-dimensional virtual environment with high-quality visuals and audio, enabling individuals to learn through experiential learning by simulating realistic scenarios. This application can also increase patients' skill proficiency and motivation. However, our review of the relevant literature revealed no studies using virtual reality headsets as a method for providing diabetic foot education. In light of the above, this study, which examines the impact of diabetic foot education provided to patients via virtual reality headsets on foot care behaviors, is expected to be unique compared to similar studies. The research results are expected to contribute significantly to the prevention of diabetic foot ulcers and the provision of optimum diabetic foot care.

Developing preventive diabetic foot care practices in a virtual environment and demonstrating them to patients using VR headsets: An educational video prepared in a virtual environment based on literature and expert opinions (the educational content was developed in accordance with the Printable Materials Patient Education Material Assessment Tool (HEMDA-B) by consulting an endocrinologist, a podiatrist, a diabetes education nurse, and nine faculty members from various universities). This video will be integrated into VR headsets and demonstrated to patients. The educational content will cover the importance of diabetes and the diabetic foot, risk factors for the diabetic foot, the causes of diabetic foot and diabetic foot symptoms, preventive foot care behaviors, how to perform a self-foot examination, proper nail care, choosing appropriate socks and shoes, insole requirements for patients diagnosed with diabetes mellitus, when to consult a healthcare professional for foot care, and examples of diabetic foot cases with visual examples. Another important aspect of this study is that no study in the literature has been found where preventive diabetic foot education developed in a virtual environment has been implemented using VR headsets. • The training will be provided five times: at baseline, at 4, 8, 12, and 24 weeks. Since patients will be called to the hospital as part of their routine checkups, it will not create any financial or emotional burden.

• The study will include patients who have not previously experienced diabetic foot ulcers. No training program has been found in the literature for patients diagnosed with type 2 diabetes who wear SG glasses. It is believed that this training, unlike traditional learning methods, will provide patients with the opportunity to learn more actively, through hands-on experience, the importance of foot care, how to perform it, and where they have made mistakes in the past.
• This group was chosen because diabetic foot problems are the only complication of diabetes that can be prevented through education. The education provided leads to significant reductions in wound formation and amputations. Preventing diabetic foot problems through education and simple measures is much easier than treating the problem.

Inclusion Criteria:

• Patients who were diagnosed with type 2 diabetes at least six months ago
• Those who are over 18 years of age
• Those who volunteer to participate in the study
• Those who can read and write
• Those who have no problems accessing the internet
• Those who have the ability to use a telephone
• Those who do not have sensory losses such as vision or hearing
• Those who do not have communication problems or those who do not have a perception or psychiatric disease diagnosis that would prevent communication
• Those who do not have ulceration in the foot and/or ankle area and/or who have not been diagnosed with diabetic foot will be included in the study.

Exclusion Criteria:

• Individuals who do not meet the criteria for inclusion in the study will be excluded from the study.