Factors influencing foot care behavior among patients with type 2 diabetes mellitus who have a high-risk diabetic foot in China

Abstract

Background & Aim: Foot ulceration and amputation have increased significantly among Chinese patients with type 2 diabetes mellitus. Proper foot care behavior is an important strategy for reducing the risk of diabetes-related foot issues. The current study aimed to assess foot care behavior and its influencing factors, including self-efficacy, foot care knowledge, and social support, among patients with type 2 diabetes mellitus who have a high-risk diabetic foot in Wenzhou, China. Methods & Materials: This research used a correlational predictive design. In total, 107 participants who were eligible for the study were randomly selected. Five self-reported questionnaires, including the demographic questionnaire, Diabetes Self-Efficacy Scale, Foot Care Knowledge questionnaire, Perceived Social Support Scale, and Chinese version of the Nottingham Assessment of Functional Footcare, were utilized. Descriptive statistical and standard multiple linear regression analyses were performed to evaluate data. Results: Approximately 90.7% of participants had poorly controlled diabetes (HbA1c≥ 7%), and 95.3% presented with foot deformities. Further, 51.4% of participants reported moderate foot care behavior, and 42.1% had poor foot care behavior. The multiple regression analysis revealed that self-efficacy, foot care knowledge, and social support significantly explained 31.1 % of the variability in foot care behavior. However, self-efficacy could predict foot care behavior (β= .490, p< .001). Conclusion: It is important to improve foot care behavior among patients with type 2 diabetes who have a high-risk diabetic foot. Nursing interventions to enhance foot care behavior should focus on improving self-efficacy and providing foot care education regularly.

Keywords

• type 2 diabetes mellitus; diabetic foot; foot care behavior; foot care knowledge; self-efficacy