Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center

Erva Magbanua, Rebecca Lim-Alba

Abstract

Objective. The objective of this study is to measure the level of knowledge and practice of diabetic foot self-care and determine the factors that affect the level and knowledge and practice of diabetic foot self-care among diabetic patients.

Methodology. Three hundred thirty adult diabetic patients at the outpatient clinics were given self-administered questionnaires on knowledge and practice of diabetic foot self-care. The scores were computed based on their answers. A score of >70% was gauged as good, 50 to 70% as satisfactory and <50% as poor.

Results. Of the subjects, 82.7% had good foot care knowledge, 22.4% had good foot self-care practice, and 71% had satisfactory practice score. Patients who received diabetes education were twice as likely to have a good knowledge score (OR 2.41, 95% CI, 1.09 to 5.32; p=0.03). Compared to patients who received diabetes care in private clinics, those who attended the charity outpatient clinic were nearly three times as likely to have a good knowledge score (OR 2.8, 95% CI, 1.32 to 5.96; p=0.007). Patients with known diabetes for more than ten years and those with a family history of diabetes were 50% less likely to have good practice scores (OR 0.50, 95% CI, 0.28 to 0.90; p=0.021 and OR 0.49, 95% CI, 0.29 to 0.83; p=0.008, respectively).

Conclusion. The current state of foot care knowledge in Filipino diabetic respondents is good but the level of foot self-care practice is only satisfactory.

Keywords

diabetic foot, diabetes mellitus, knowledge, self-care

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References

Abbott CA, Carrington AL, Ashe H, et al. The North-West Diabetes Foot Care Study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort. Diabetic Med. 2002;19(5):377-84. PMID: 12027925. https://doi:10.1046/j.1464-5491.2002.00698.x.

Ramsey SD , Newton K, Blough D, et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care. 1999;22(3):382-7. PMID:10097914. https://doi.org/10.2337/diacare.22.3.382.

Boulton AJ, Armstrong DG, Albert SF, et al. Comprehensive foot examination and risk assessment: A report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care. 2008;31(8):1679-85. PMID: 18663232. PMCID: PMC2494620. https://doi.org/10.2337/dc08-9021.

Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with Diabetes. JAMA. 2005;293(2):217-28. PMID: 15644549. https://doi.org/10.1001/jama.293.2.217.

Chandalia HB, Singh D, Kapoor V, Chandalia SH, Lamba PS. Footwear and foot care knowledge as risk factors for foot problems in Indian diabetics. Int J Diabetes Dev Ctries. 2008;28(4):109-13. PMID: 20165597. PMCID: PMC2822153. https://doi.org/10.4103/0973-3930.45269.

Mayfield JA, Reiber GE, Sanders LJ, Janisse D, Poqach LM; American Diabetes Association. Preventive foot care in diabetes. Diabetes Care. 2004;27(Suppl 1):S63-4. PMID: 14693928.

Pinzur MS, Slovenkai, MP, Trepman E, Shields NN; Diabetes Committee of American Orthopaedic Foot and Ankle Society. Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society. Foot Ankle Int. 2005;26(1):113-9. PMID: 15680122. https://doi.org/10.1177/107110070502600112.

Bonner T, Foster M, Spears-Lanoix E. Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: A systematic review of the literature. Diabet Foot Ankle. 2016;7:29758. PMID: 26899439. PMCID: PMC4761684. https://doi.org/ 10.3402/dfa.v7.29758. eCollection 2016.

Matricciani L, Jones S. Who cares about foot care? Barriers and enablers of foot self-care practices among non-institutionalized older adults diagnosed with diabetes: An integrative review. Diabetes Educ. 2015;41(1):106-17. PMID: 25480398. https://doi.org/10.1177/0145721714560441.

Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc. 2009;59(10):687-90. PMID: 19813683.

Lincoln NB, Jeffcoate WJ, Ince P, Smith M, Radford K. Validation of a new measure of protective footcare behaviour: The Nottingham Assessment of Functional Footcare (NAFF). Pract Diab Int. 2007;24(4):207-11. https://doi.org/10.1002/pdi.1099.

Polit DF, Yang FM. Measurement and the measurement of change. Philadelphia: Wolters Kluwer, 2016.

UNITE for Diabetes Philippines: Philippine Practice Guidelines on the Diagnosis and Management of Diabetes Mellitus. http://obesity.org.ph/v4/wp-content/uploads/2014/07/Diabetes-United-for-Diabetes-Phil.pdf. Accessed August 1, 2016.

Philippine Statistics Authority. 2012 Family Income and Expenditure Survey Final Results: National Capital Region. Number: 2014-11. http://nso-ncr.ph/special%20release/fies/2012%20Fies.

pdf. Accessed August 6, 2016.

Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM. Knowledge and practice of diabetic foot care in an in-patient setting at a tertiary medical center. Malays Orthop J. 2014;8(3):22-6. PMCID: PMC4536395. https://doi.org/10.5704/MOJ.1411.005.

Seid A, Tsige Y. Knowledge, practice, and barriers of foot care among diabetic patients attending Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Advances in Nursing. 2015;2015:Article ID 934623. https://doi.org/ 10.1155/2015/934623.

Desalu OO, Salawu FK, Jimoh AK, Adekoya AO, Busari OA, Olokoba AB. Diabetic Foot Care: self reported knowledge and practice among patients attending three tertiary hospital in Nigeria. Ghana Med J. 2011;45(2):60-5. PMID: 21857723. PMCID: PMC3158533.

Mcmillan G, Hanson TE. Sample size requirements for establishing clinical test-retest standards. Ear Hear. 2014;35(2): 283-6. PMID: 24351613. https://doi.org/10.1097/01.aud.0000438377.150036b.

Peacock J, Peacock PJ. Oxford handbook of medical statistics. Oxford: Oxford University Press, 2011.

George H, Rakesh P, Krishna M, et al. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in southern India. J Family Med Prim Care. 2013;2(1):27-32. PMID: 24479039. PMCID: PMC3894008. https://doi.org/ 10.4103/2249-4863.109938.

Li R, Yuan L, Guo KH, et al. The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China. International Journal of Nursing Sciences. 2014; 1(3):266-71. https://doi.org/10.1016/j.ijnss.2014.05.023.

Isip J, de Guzman M, Ebison A Jr, Narvacan-Montano C. Footwear appropriateness, preferences and foot ulcer risk among adult diabetics at Makati Medical Center Outpatient Department. J ASEAN Fed Endocr Soc. 2016;31(1):37-43. https://doi.org/10.15605/jafes.031.01.07.

Kumhar M, Dara N, Saini T. Foot wear and footcare knowledge—an independent risk factor for diabetic foot in Indian diabetics. Indian Medical Gazette. 2014;25-8. http://imsear.hellis.org/handle/123456789/157578.

Khamseh ME, Vatankhah N, Baradaran HR. Knowledge and practice of foot care in Iranian people with type 2 diabetes. Int Wound J. 2007;4(4):298-302. PMID: 18154624. https://doi.org/10.1111/j.1742-481X.2007.00381.x.

Hernandez-Tejada MA, Campbell JA, Walker RJ, Smalls BL, Davis KS, Egede LE. Diabetes empowerment, medication adherence and self-care behaviors in adults with type 2 diabetes. Diabetes Technol Ther. 2012;14(7):630-4. PMID: 22524548. PMCID: PMC3389377. https://doi.org/10.1089/dia.2011.0287.

Kim SY, Hongsranagon P. Preventive behaviors regarding foot ulcers in diabetes type II patients at BMA Health Center No. 48, Bangkok, Thailand. J Health Res. 2008;22(Suppl):21-8. http://www.jhealthres.org/upload/journal/341/22(suppl)_p21-28_sonyongkim.pdf.

Malathy R, Narmadha M, Ramesh S, Alvin JM, Dinesh BN. Effect of a diabetes counseling programme on knowledge, attitude and practice among diabetic patients in Erode district of South India. J Young Pharm. 2011;3(1):65-72. PMID: 21607057. PMCID: PMC3094563. https://doi.org/10.4103/0975-1483.76422.

Nongmaithem M, Bawa AP, Pithwa AK, Bhatia SK, Singh G, Gooptu S. A study of risk factors and foot care behavior among diabetics. J Family Med Prim Care. 2016;5(2):399-403. PMID: 27843849. PMCID: PMC5084569. https://doi.org/10.4103/2249-4863.192340.

Nagpal J, Bhartia A. Quality of diabetes care in the middle- and high-income group populace: The Delhi Diabetes Community (DEDICOM) Survey. Diabetes Care. 2006;29(11):2341-8. PMID: 17065665. https://doi.org/10.2337/dc06-0783.