Factors Affecting Foot Self-Care Practices in Individuals with Diabetes Mellitus Living in an Asian Population - A Quantitative Study

Abstract

Category: Diabetes Introduction/Purpose: Diabetic foot complications and subsequent lower limb amputations commonly occur in diabetic patients due to poor foot care. We aimed to understand the extent of proper footcare practices and to identify the factors which influence these among diabetic patients in a multi-ethnic Asian population. Methods: A cross-sectional multi-centre quantitative study was performed. Inclusion criteria was all patients attending hospital outpatients clinics for diabetes. Patients were only excluded if they were unable to understand basic English. Demographic information, medical history (including formal assessment for peripheral neuropathy) and Nottingham Assessment of Functional Footcare (NAFF) scoreswere collected. All data was analysed using SPSS Version 21. Results: 350 valid responses were obtained. The mean NAFF score was 49.6±7.19. Univariate analysis revealed that ethnically non-Chinese patients had significantly better scores than did Chinese patients. After linear regression analysis, a statistically significant correlation with better foot care practices was found for patients with higher education levels, active employment and the presence of previous diabetic foot complications. Conclusion: The mean NAFF scores in our study were lower than those published in other populations which may in part account for the huge burden of diabetic foot disease in Singapore. Patients appear to start to look after their feet better only after suffering a complication.Cultural and financial factors probably account for the differences in our risk factor findings and those published in other populations. Future studies should i evaluate the effectiveness of targeted interventions for the specific groups that we have identified who have poorer NAFF scores.