Development of a Patient-Centered Daily Foot Self-Care Protocol for High-Risk Diabetic Foot Patients Based on Checklist Management Model: A Delphi Study

Background: The International Diabetic Foot Working Group emphasizes that daily foot self-care is a critical measure for preventing diabetic foot ulcers, with patients serving as the primary implementers. However, there is a notable lack of patient-centered, specific, and actionable care management plans. This study aims to develop a scientifically sound, standardized, and practical daily foot self-care protocol for high-risk diabetic foot patients based on the checklist management model. Methods: This study was conducted in two sequential phases. First,a preliminary draft of the foot self-care program was developed through a comprehensive literature review and semi-structured interviews with healthcare professionals and patients. Subsequently, from December 2024 to January 2025, the Delphi method was employed to conduct two rounds of expert consultation with 17 specialists, during which the indicators were screened and refined based on predefined criteria. Results: In the first and second rounds of expert consultations, 18 and 17 questionnaires were distributed, respectively, with 17 valid responses returned each round, yielding effective response rates of 94.44% and 100%. The expert authority coefficient was 0.93, indicating high credibility. The Kendall's harmony coefficients were 0.168 and 0.272 (p