A study to determine the knowledge and practice of foot care in patients with chronic diabetic ulcers

Introduction: Diabetic foot ulcers accounts for many hospital admissions and it is also a major cause of amputations. More importantly it is preventable by effective identification, education and preventive foot care practice. Therefore, lifestyle modification remains a cornerstone of management.

Objective: Determine the level of knowledge and practice of foot care among patients with chronic diabetic foot ulcers.

Methodology: Individuals having diagnosed diabetic foot ulcers (n=110) were selected from National Hospital of Sri Lanka (NHSL) for this descriptive cross sectional study. They were given an interviewer administered, pre tested questionnaire following informed consent. Patient perceptions of foot care were inquired. A scoring system ranging from 0-10 was employed to analyze the responses given for level of knowledge and practice of diabetic foot care. The study was approved by the Ethics Review Committees of Faculty of Medicine, Colombo.

Results: Mean age was 58.4 years (SD ±8.6) and 57.3% were males. Non healing ulcers were present among 82.7% and amputations amounted to 38.2%. The control of diabetes was poor in 60%. Regarding foot care knowledge, the mean score was 8.37, 75.5% had scored above mean and 52.7% were aware of all principles of foot care. Regarding foot care practices, the mean score was 4.55, 47.3% participants had scored below mean and 22.7% did not practice any foot care principle and hence scored 0. A Statistically significant difference exists between the foot care knowledge and practice scores (p<0.001, z= -8.151). In the study sample 51% were not educated prior to occurrence of complications.

Conclusion: Results demonstrate a satisfactory knowledge on diabetic foot disease; however their practices of preventive techniques were unsatisfactory. Implementation of a national policy on diabetic foot management and good patient follow-up to increase compliance would help to improve this situation.

Author(s): Chamil Vidusha Madushan Jinadasa , Madawa Jeewantha

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