Original Article: Practice and associated factors regarding foot care among diabetes mellitus patients attending a rural primary health center in South India

Authors

1 Department of Community Medicine, KAHERs J.N. Medical College,

2 KLES Diabetes Centre, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi

3 Department of Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India

Abstract

Background: Diabetes mellitus patients are more likely to undergo nontraumatic foot or leg amputations because they have decreased circulation to the feet or reduced sensation. This condition may cause ulcerations, infections, and delayed wound healing, leading to amputations. Adequate knowledge and practices regarding foot care will be vital in the prevention of diabetic foot complications. Hence, this study aimed to determine the level of knowledge and practices of foot care among diabetes mellitus patients attending a rural primary health center in Belagavi-South India. Materials and Methods: A cross-sectional study was conducted in the rural field practice area of J.N. Medical College, Belagavi, for 7 months (November 2019 to May 2020). A pretested questionnaire was administered to 461 diabetes patients attending the health center. A written informed consent was obtained from each participant. They were interviewed with a questionnaire consisting of 15 “yes” or “no” questions, each on foot care knowledge and practice. Results: The mean age of the study participants was 50.28 ± 9.48 years. The mean duration of diabetes was 10.69 ± 7.09 years. Majority, i.e., 296 (64.2%) participants showed satisfactory knowledge and 293 (63.6%) showed satisfactory practice. Only 97 (21%) had poor knowledge, 90 (19.5%) had poor practice, 68 (14.8%) patients had good knowledge, and 78 (16.9%) had good practice about diabetic foot care. Conclusions: The low level of knowledge and practice in patients with diabetes regarding foot care necessitates an educational program to increase awareness related to foot complications of diabetes, thereby motivating diabetic patients to incorporate foot care practices in their day-to-day routine.

Keywords

1.
India State-Level Disease Burden Initiative Diabetes Collaborators. The increasing burden of diabetes and variations among the states of India: The Global Burden of Disease Study 1990-2016. Lancet Glob Health 2018;6:e1352-62.  Back to cited text no. 1
    
2.
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014;103:137-49.  Back to cited text no. 2
    
3.
Tachkov K, Mitov K, Koleva Y, Mitkova Z, Kamusheva M, Dimitrova M, et al. Life expectancy and survival analysis of patients with diabetes compared to the non diabetic population in Bulgaria. PLoS One 2020;15:e0232815.  Back to cited text no. 3
    
4.
Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: A systematic review and meta-analysis. Ann Med 2017;49:106-16.  Back to cited text no. 4
    
5.
Ghosh P, Valia R. Burden of diabetic foot ulcers in India: Evidence landscape from published literature. Value Heal 2017;20:A485.  Back to cited text no. 5
    
6.
Schaper NC, Apelqvist J, Bakker K. The international consensus and practical guidelines on the management and prevention of the diabetic foot. Curr Diab Rep 2003;3:475-9.  Back to cited text no. 6
    
7.
Kumpatla S, Kothandan H, Tharkar S, Viswanathan V. The costs of treating long-term diabetic complications in a developing country: A study from India. J Assoc Physicians India 2013;61:102-9.  Back to cited text no. 7
    
8.
García-Morales E, Lázaro-Martínez JL, Martínez-Hernández D, Aragón-Sánchez J, Beneit-Montesinos JV, González-Jurado MA. Impact of diabetic foot related complications on the health related quality of life (HRQoL) of patients-A regional study in Spain. Int J Low Extrem Wounds 2011;10:6-11.  Back to cited text no. 8
    
9.
Alrub AA, Hyassat D, Khader YS, Bani-Mustafa R, Younes N, Ajlouni K. Factors associated with health-related quality of life among Jordanian patients with diabetic foot ulcer. J Diabetes Res 2019;2019:4706720.  Back to cited text no. 9
    
10.
Al Ayed M, Ababneh M, Alwin Robert A, Al Misfer N, Cruz M, Austria HC, et al. Factors associated with health-related quality of life in patients with diabetic foot ulcer: A cross-sectional study from Saudi Arabia. Cureus 2020;12:e8658.  Back to cited text no. 10
    
11.
Ralineba T, Netshikweta ML. Knowledge and practices associated with diabetes among patients with chronic diabetes mellitus in rural areas of Vhembe District, Limpopo Province, South Africa. J Hum Ecol 2015;51:193-201.  Back to cited text no. 11
    
12.
Pavithra H, Akshaya KM, Nirgude AS, Balakrishna AG. Factors associated with awareness and practice about foot care among patients admitted with diabetes mellitus: A cross sectional research from a medical college hospital of southern India. Nepal J Epidemiol 2020;10:897-904.  Back to cited text no. 12
    
13.
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;59:687-90.  Back to cited text no. 13
    
14.
Lavsa SM, Holzworth A, Ansani NT. Selection of a validated scale for measuring medication adherence. J Am Pharm Assoc (2003) 2011;51:90-4.  Back to cited text no. 14
    
15.
IBM Corp. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp; 2013.  Back to cited text no. 15
    
16.
Pandey VK, Aggarwal P, Kakkar R. Modified BG Prasad socio-economic classification, update-2019. Indian J Community Heal 2019;31:123-5.  Back to cited text no. 16
    
17.
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;8:22-6.  Back to cited text no. 17
    
18.
Shalom A, Friedman T, Wong L. Burns and diabetes. Ann Burns Fire Disasters 2005;18:31-3.  Back to cited text no. 18
    
19.
Sutariya P, Kharadi A. Knowledge and practice of foot care among the patients of diabetic foot: A hospital based cross-sectional study. Int Surg J 2016;3:1850-5.  Back to cited text no. 19
    
20.
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;45:60-5.  Back to cited text no. 20
    
21.
Abdulghani HM, AlRajeh AS, AlSalman BH, AlTurki LS, AlNajashi NS, Irshad M, et al. Prevalence of diabetic comorbidities and knowledge and practices of foot care among diabetic patients: A cross-sectional study. Diabetes Metab Syndr Obes 2018;11:417-25.  Back to cited text no. 21
    
22.
Saber HJ, Daoud AS. Knowledge and practice about the foot care and the prevalence of the neuropathy among a sample of type 2 diabetic patients in Erbil, Iraq. J Family Med Prim Care 2018;7:967-74.  Back to cited text no. 22
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23.
Al-Asmary AS, Sama Mostafa OA, Al-khaldi YM, Mostafa OA. Diabetic patients' knowledge and practice regarding prevention of diabetic foot. Med J Cairo Univ 2013;81:197-205.  Back to cited text no. 23
    
24.
Chellan G, Srikumar S, Varma AK, Mangalanandan TS, Sundaram KR, Jayakumar RV, et al. Foot care practice-The key to prevent diabetic foot ulcers in India. Foot (Edinb) 2012;22:298-302.  Back to cited text no. 24
    
25.
Ramirez-Perdomo C, Perdomo-Romeroa A, Rodríguez-Véleza M. Knowledge and practices for the prevention of the diabetic foot. Rev Gaucha Enferm 2019;40:1-7.  Back to cited text no. 25
    
26.
Natalia de Sá P, Moura JR, de Melo Júnior EB, de Almeida PC, de Macêdo SF, da Silva AR. Knowledge, attitudes and practices for the prevention of diabetic foot. Rev Gaucha Enferm 2014;35:36-42. [in Por].  Back to cited text no. 26
    
27.
Pourkazemi A, Ghanbari A, Khojamli M, Balo H, Hemmati H, Jafaryparvar Z, et al. Diabetic foot care: Knowledge and practice. BMC Endocr Disord 2020;20:40.  Back to cited text no. 27
    
28.
Li R, Yuan L, Guo XH, Lou QQ, Zhao F, Shen L, 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. Int J Nurs Sci 2014;1:266-71.  Back to cited text no. 28
    
29.
Gökdeniz D, Akgün Şahin Z. Evaluation of knowledge levels about diabetes foot care and self-care activities in diabetic individuals. Int J Low Extrem Wounds 2022;21:65-74.  Back to cited text no. 29
    
30.
Yılmaz Karadağ F, Saltoğlu N, Ak Ö, Çınar Aydın G, Şenbayrak S, Erol S, et al. Foot self-care in diabetes mellitus: Evaluation of patient awareness. Prim Care Diabetes 2019;13:515-20.  Back to cited text no. 30
    
31.
Abu-Qamar MZ. Knowledge and practice of foot self-care among Jordanians with diabetes: An interview-based survey study. J Wound Care 2014;23:247-50, 252-4.  Back to cited text no. 31
    
32.
Chiwanga FS, Njelekela MA. Diabetic foot: Prevalence, knowledge, and foot self-care practices among diabetic patients in Dar es Salaam, Tanzania-A cross-sectional study. J Foot Ankle Res 2015;8:20.  Back to cited text no. 32
    
33.
Sari Y, Upoyo AS, Isworo A, Taufik A, Sumeru A, Anandari D, et al. Foot self-care behavior and its predictors in diabetic patients in Indonesia. BMC Res Notes 2020;13:38.