A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Abstract The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients' age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices

Knowledge and attitude of nurses towards diabetic foot care in a secondary health care centre in Malaysia

@#Introduction: Nurses play a vital role in the care and prevention of ulcers in patients with diabetic foot. Patient education, prevention of ulcers and rehabilitation are some of the vital aspects that nurses provide on a daily basis. Thus, good knowledge and attitude of nurses towards diabetic foot ulcers and its care will ensure better patient care. Objectives: The aim is to study the level of knowledge and attitude of nurses towards diabetic foot ulcers and its care in Hospital Segamat, Malaysia. Methods: A validated questionnaire was used between February 2019 to May 2019 covering area such as demography, predisposing factors of ulcer formation, characteristics of ulcers, complications of ulcers, and attitude towards diabetic foot care. Results: A total of 101 nurses took part and 57% of the participants scored poorly in the knowledge section of the questionnaire. In all 72% had scored poorly when asked regarding complications of diabetic foot ulcers; 49.5% of the nurses had positive attitude towards diabetic foot care; and 79.3% thought that care for diabetic foot ulcer is timeconsuming. Majority of them think that their colleagues are the main source of information. All demographic variables were deemed to be confounders with the knowledge and attitude of nurses towards diabetic foot ulcers and its care. Conclusions: Nurses in this centre had poor knowledge towards diabetic foot ulcers and its care. None of the variable studied were correlated with the level know knowledge. Good or poor knowledge of nurses does not correspond equally to good or poor attitude towards diabetic foot ulcers care. More frequent formal training of diabetic foot care would be needed to ensure better knowledge.

Foot care practices, its barriers and risk for peripheral neuropathy among diabetic patients attending medical college in rural Puducherry

Background: Diabetes has becoming an increasing cause of morbidity and mortality worldwide. Along with the rising prevalence of diabetes increase in the complications are expected which will further burden our health care services. Poor knowledge of foot care and poor foot care practices were identified as important risk factors for foot problems in diabetes.Methods: The present study was a mixed methods study conducted among diabetic patients attending medicine OPD. Quantitative data for foot care practices and peripheral neuropathy was collected from 190 diabetic patients and free listing among 20 diabetic patients was done to identify perceived barriers for foot care practices. Collected data were entered in Epi Info (3.5.3) and analysed using SPSS version 24 software.Results: The prevalence of peripheral neuropathy among the study participants was 52.9%. Significant association was found between peripheral neuropathy and male sex (p=0.006), occupation (p=0.003), smoking status (p=0.013) and longer duration of disease (p=0.04). The various reasons for poor foot care practices perceived by patients were poor knowledge about foot care, lack of knowledge about complications and health care provider did not teach them.Conclusions: The prevalence of peripheral neuropathy is common among diabetic patients and most of them are having poor foot care practices so there is a need in the community to lay emphasis on health education programs to improve foot care practices.

An investigation of foot care behavior and multiple linear regression analysis of influential factors in patients with type 2 diabetes mellitus in Jinshan District of Shanghai / 中国实用护理杂志

Objective To investigate the level of foot care behaviors of in patients with type 2 diabetes mellitus in Jinshan District of Shanghai, analyze the influential factors, and provide information for the intervention study. Methods With convenient sampling method, a questionnaire survey was conducted with a sample of 110 inpatients with type 2 diabetes mellitus from Jinshan District of Shanghai. The investigation contents included patients′ demographic data, foot care knowledge and behaviors. The investigation tools were the questionnaire of diabetes general information, the questionnaire of foot care knowledge, and the questionnaire of foot care behaviors. Survey tools included general information questionnaire, foot care knowledge scale for diabetic patients and Nottingham Foot Care Assessment Scale in Chinese version. Independent-samples t test and oneway ANOVA were used in univariate analyses, whereas multiple stepwise linear regression was used in multivariate analyses. And Pearson correlation analysis was used to measure correlation between variables. Results The scores of foot care behaviors were statistically significant in the group comparison of sex and glycosylated hemoglobin(t=-2.142, F=3.071, P<0.05). The patients′score of foot care behaviors was (45.31±7.74) scores.50.9 percent (54/106) patients′scores were less than 45.And the score of foot care knowledge was (16.10±4.18) scores, which was in the medium level. The foot care behaviors level was lower in the patients whose foot care knowledge was poorer (t=-5.591, P<0.01). Foot care knowledge, glycosylated hemoglobin level and gender were the main influencing factors on foot care behaviors of type 2 diabetic patients (R2=0.221, F=9.664, P=0.000). Pearson analysis demonstrated that there was a positive correlation between knowledge score, glycosylated hemoglobin level and behavior score (r=0.377, 0.207, P<0.05). Conclusions The status of foot care knowledge and behaviors of type 2 diabetic patients are not optimistic in Jinshan District of Shanghai. It′s very important to strengthen the education and management on diabetic patients′foot care knowledge and behaviors, especially in male patients. Meanwhile, the patients whose glycosylated hemoglobin are well controlled should not be ignored.

An investigation of foot care behavior and multiple linear regression analysis of influential factors in patients with type 2 diabetes mellitus in Jinshan District of Shanghai / 中国实用护理杂志

Objective@#To investigate the level of foot care behaviors of in patients with type 2 diabetes mellitus in Jinshan District of Shanghai, analyze the influential factors, and provide information for the intervention study.@*Methods@#With convenient sampling method, a questionnaire survey was conducted with a sample of 110 inpatients with type 2 diabetes mellitus from Jinshan District of Shanghai. The investigation contents included patients′ demographic data, foot care knowledge and behaviors. The investigation tools were the questionnaire of diabetes general information, the questionnaire of foot care knowledge, and the questionnaire of foot care behaviors. Survey tools included general information questionnaire, foot care knowledge scale for diabetic patients and Nottingham Foot Care Assessment Scale in Chinese version. Independent-samples t test and oneway ANOVA were used in univariate analyses, whereas multiple stepwise linear regression was used in multivariate analyses. And Pearson correlation analysis was used to measure correlation between variables.@*Results@#The scores of foot care behaviors were statistically significant in the group comparison of sex and glycosylated hemoglobin(t=-2.142, F=3.071, P<0.05). The patients′score of foot care behaviors was (45.31±7.74) scores. 50.9 percent (54/106) patients′scores were less than 45. And the score of foot care knowledge was (16.10±4.18) scores, which was in the medium level. The foot care behaviors level was lower in the patients whose foot care knowledge was poorer (t=-5.591, P<0.01). Foot care knowledge, glycosylated hemoglobin level and gender were the main influencing factors on foot care behaviors of type 2 diabetic patients (R2=0.221, F=9.664, P=0.000). Pearson analysis demonstrated that there was a positive correlation between knowledge score, glycosylated hemoglobin level and behavior score (r=0.377, 0.207, P<0.05).@*Conclusions@#The status of foot care knowledge and behaviors of type 2 diabetic patients are not optimistic in Jinshan District of Shanghai. It′s very important to strengthen the education and management on diabetic patients′foot care knowledge and behaviors, especially in male patients. Meanwhile, the patients whose glycosylated hemoglobin are well controlled should not be ignored.

Diabetes self care activities among adults 20 years and above residing in a resettlement colony in East Delhi

Background: Self-care activities are the cornerstone of diabetes care that ensures patients participation to achieve optimal glycemic control and to prevent complications. Objective: The aim of this study is to find the level of self-care activities among diabetics aged ?20 years residing in a resettlement colony in East Delhi and its association with sociodemographic factors, disease, and treatment profile. Methods: Using cross-sectional survey, 168 known diabetic patients were selected from Nand Nagri, a resettlement colony in East Delhi. Data were collected using Hindi translation of revised version-Summary of Diabetic Self Care Activities along with a pretested semi-open-ended questionnaire. Self-care was assessed on six parameters as follows: (a) general diet, (b) specific diet, (c) exercise, (d) blood sugar testing, (e) foot-care, and (f) smoking. The study period was from November 2014 to April 2016. Results: Nearly 35.1% of respondents belonged to 60� years age group. About 52.4% of respondents were female. Fifty-two diabetics (31%) reported having practised diet control on all 7 days in the past 1 week. Nearly 39.3% of patients did not perform any physical activity. The blood test was not practised by 92.3% of respondents. Foot-care was practised by only 19% of patients. There was a significant association between general diet among diabetics with family support (P = 0.020), place of diagnosis (P = 0.033), and treatment funds (P = 0.017). The exercise score among diabetics who were below the poverty line was higher than those above poverty line (P = 0.029). Younger age (P = 0.005) and treatment with insulin (P = 0.008) were positively associated with blood glucose testing. The foot-care practice was better in patients aware of complications and foot-care practices (P < 0.001). Conclusion: Self-care activities among diabetic patients were very poor. Self-management educational programs at hospitals along with information, education, and communication activities at the community level and one-to-one counseling are recommended.

Foot Care for Diabetic Patients / 임상당뇨병

The incidence of diabetes is increasing not only in Korea, but also globally. Diabetes mellitus is a disease with problematic complications. Diabetic foot is a typical complication that reduces the quality of life and is a burden on the economy. Active foot examination and foot care education are methods to prevent diabetic foot at a minimum cost. Early detection, treatment, and education are the primary responsibilities of healthcare providers.

Adherence of Diabetic Patients to Education Information Provided at Primary Health Care Level in Khartoum State, Sudan.

Introduction: Diabetes mellitus needs medical care and education. Adherence of the diabetic patients to education information provided at primary care level have been scantly documeneted. Objective: To measure the adherence of diabetic patients to education information provided at health centers. Methods: A cross sectional study was carried out in 25 governmental health centers (Gov.HCs) and 15 non-governmental health centers (Non-Gov.HCs). Study population was 419 adult diabetic males /females known beneficiaries of the services in the study centers. Patients were interviewed by structured questionnaire. Descriptive statistic presented the patients profile, as well as the education information received by the patients and the levels of patients’ adherence. Fisher exact test at 95% confidence level used to test differences in education information services. Adherence of patients to education information was measured by three points Likert scale. Chi square test used to test the difference in adherence. Ethical clearance and written consent were obtained. Results: The mean age was 55.2±10.2 years. Males and females were 44.6% and 55.4% respectively. Education accounted to 76.4%. Family income above 1000 Sudanese Geneh (SDG) accounted to 64.2%. Doctors provided education information about physical activities to 64.6% and 46.2% patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.014. Diet plan received by 73.6% and 55.8% of patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.013. Information on how to measure blood glucose at home received by 48.2% and 25.0% of patients in Gov.HCs and Non-Gov.HCs respectively, P-value 0.002. Very few patients received information from educators, 0.2% and 3.4% of patients in Gov.HCs and Non-Gov.HCs respectively. Foot care education information provided to 25.3% of patients. Adherence of diabetic patients to education information provided was adequate but does not significantly differ between the types of the health centers Conclusions: Education information services were significantly high in Gov.HCs. Adherence of diabetic education information was adequate.

An investigation of foot care behavior in patients with high risk of type 2 diabetic foot and analysis of influencing factors / 中国实用护理杂志

Objective To investigate the level of foot care behavior and analyse related influencing factors in patients with high risk of type 2 diabetic foot (DF).Methods Apply the Chinese version of the Nottingham Assessment of Functional Footcare to 300 cases of patients with high risk of DF and take oneway ANOVA and multiple stepwise linear regression analysis on the general information and current foot condition.Results The score of foot care behavior was (45.58 ±7.83) scores.52.3 percents patients' scores were less than 45.Gender,previous education of diabetic foot care and history of diabetic foot ulcer were influencing factors of foot care behavior in patients with high risk of type 2 diabetic foot (t=3.196,3.392,2.462,P＜0.05).Conclusions The current level of foot care behavior was relatively low in patients with high risk of type 2 DF.It was also approved that female patients with high risk of DF who had received diabetic foot care education and suffered from diabetic foot ulcer before score much higher on foot care behavior.

Foot Wear and Footcare Knowledge - An Independent Risk Factor for Diabetic Foot in Indian Diabetics.

Diabetic foot lesions are significant health and socioeconomic problems holding adverse effect on the quality of life and imposing a heavy economic burden on patient or state. In Indian diabetics poor knowledge about footwear and foot care ,social and religious customs like walking barefoot, walking on fire also have significant role in diabetic foot problems beside traditional risk factor like peripheral neuropathy, peripheral vascular disease.

Knowledge and Practice of Diabetic Foot Care in an In-Patient Setting at a Tertiary Medical Center

Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients’ knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 ‘yes’ or ‘no’ questions on foot care knowledge and practice. Score of 1 was given for each ‘yes’ answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.

Efeitos de regras sobre relatos de comportamentos de cuidados com os pés em pessoas com diabetes / Effects of rules on reports of foot care behavior of diabetes patients

Objetivando estabelecer relatos de cuidados com os pés, foram registrados relatos de adultos diabéticos (linha de base), antes das manipulações experimentais. No Experimento 1 (N=6), a Condição 1 era com perguntas e com exame dos pés. A Condição 2, sem perguntas e com exame. E a Condição 3, sem perguntas e sem exame. No Experimento 2, os 16 participantes foram expostos a regras para cuidar dos pés. Havia reforço na Condição 1; justificativas para o seguir regras na Condição 2; reforço e justificativas na Condição 3; e, não havia reforço e justificativas na Condição 4. Apenas no Experimento 2, independente da condição, as regras elevaram o número de relatos apresentados. Discutem-se os efeitos de variáveis envolvidas no controle por regras.

Aiming to establish reports on foot care, baseline reports of diabetic adults were registered before experimental manipulations. In Experiment 1, Condition 1, questions were made to 6 participants and their feet were examined. In Condition 2, no questions were made and an exam was performed. In Condition 3, no questions were made and no exam was performed. In Experiment 2, all 16 participants were exposed to rules on how to take care of their feet. In Condition 1, reports were reinforced; in Condition 2 reasons for following the rules were presented; in Condition 3 there were reinforcement and reasons; and in Condition 4, neither reinforcement for reports nor reasons were presented. In all conditions of Experiment 2, the number of reports increased. The effects of the variables involved in rule-governed behavior are discussed.

Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot / 대한지역사회영양학회지

OBJECTIVES: This study was to determine diabetes fatalism of diabetic patients with and without diabetic foot and its association with lifestyle, diet, and self-care. METHODS: The subjects were diabetic patients with (male/female 48/21) and without diabetic foot (male/female 33/26). We administered the questionnaires which were designed to determine diabetes fatalism, lifestyle, diet, and self-care. Diabetes fatalism was determined by Diabetes fatalism scale (DFS), which consisted of total 12 items in three subscales namely, emotional stress, religiou.spiritual coping, and perceived self-efficacy. RESULTS: The patients with diabetic foot had undesirable diets more frequently (1.37 and 0.91 days/week respectively) and their desirable diets (2.74 and 3.61 days/week respectively) and foot care (4.61 and 5.53 days/week respectively) were less frequent than those without diabetic foot (p < 0.05). An item analysis of the 12 DFS items revealed a Chronbach' alpha of 0.614 and 0.869, respectively in diabetic patients with and without diabetic foot. Perceived self-efficacy related DFS of subjects without diabetic foot was positively associated with smoking (r = 0.350, p < 0.01), undesirable diet (r = 0.295, p < 0.05), and drinking (r = 0.257, p < 0.05), while its negative association with exercise (r = -0.224, p < 0.088) and foot care (r = -0.247, p < 0.059) did not reach to statistical significance. CONCLUSIONS: This work was the first study reporting the potential usefulness of DFS, especially perceived self-efficacy related subscale as a predictor of lifestyle, diet and self-care on the Korean diabetic patients, at least those without severe diabetic foot to screen those who should be the first target for diabetes education.

Prevention and Education for Diabetic Foot / 임상당뇨병

Diabetic foot ulceration, which can result in amputations of the lower extremities and death, is a major complication for people with diabetes mellitus. Comprehensive foot care programs based on the International Consensus on the Diabetic Foot 2007, including regular inspections and examination of the foot at risk, identification of the foot at risk, education of patient, family and healthcare provider, recommendations of appropriate footwear, and treatment of non-ulcerative pathologies, can reduce the occurrence of foot lesions in up to 50% of patients. The objective of this overview is to discuss how to prevent diabetic foot, and educate patients with diabetic foot.

Foot Ulcer Risk, Foot Care Knowledge, and Foot Care Practice in Patients with Type 2 Diabetics / 성인간호학회지

PURPOSE: The purpose of this study was to investigate foot ulcer risk factors, foot care knowledge, and foot care practice in patients with type 2 diabetes. METHOD: One hundred fifty type 2 diabetic patients were in and out-patients in a large urban hospital. The data were collected using a self-report questionnaire, chart review and foot examination. The questionnaires were developed by the researchers through the experts consultation and literature review. High risk for foot ulcer was evaluated by peripheral neuropathy(PN), peripheral vascular disease(PVD), and prior foot ulcer. Foot risk scores(FRS) means numbers of present risk factors. RESULTS: 31.3% of subjects show 1 FRS, and 13.3% showed 2 FRS. Mean foot care frequency was 3.5 times per week. There were significant differences in foot care knowledge according to DM education (t=2.96, p=.004) and foot care education (t=3.65, p=.001). There were significant differences in the foot care practice activities according to duration of DM (t=3.48, p=.010) and educational levels. CONCLUSION: There were high proportion of foot ulcer risk among the patients. It is necessary to screen high risk foot ulcer patients and provide practical education for foot care practice of diabetic patients.

A Study on the Related Factors and the Change after Foot-reflexo-massage Education Program for Diabetic Patients / 성인간호학회지

PURPOSE: The purpose of this study was to identify the change in foot care knowledge, self care behavior, and physiologic indexes after foot reflexomassage education program, and the related factors. METHOD: Data were collected from 20 patients who were visited out patients clinic. The change and difference were analyzed with non-parametric statistics. RESULT: There were significant differences in foot care knowledge(P=.001), self care behavior(P=.000), dosalis pedis blood flow volume (P=.011), skin temperature of foot(P=.001), dorsalis pedis pulse(P=.000), capillary filling time of foot (P=.000) between pre and post. The level of changes of foot care knowledge was significant differences according to admission experience (P=.049), and negative related to systolic blood pressure(P=.028). The level of changes of self care behavior was related to age(P=.049), that of dosalis pedis blood flow was significant difference according to smoking(P=.042), that of skin temperature of foot(P=.002) and dosalis pedis pulse(P=.038) were significant difference according to weight. The level of changes of capillary filling time of foot was related to diagnosis period(P=.014). CONCLUSION: Foot- Reflexo-Massage education program is an effective nursing intervention to promote foot care in diabetic patients. And the related factors can be recommended for the management of diabetic patients.

The Effects of a Foot-Reflexo-Massage Education Program on Foot Care in Diabetic Patients / 간호학회지

PURPOSE: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. METHOD: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. RESULT: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. CONCLUSION: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.