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Omotosho TOA, Sanyang Y, Senghore T. Diabetic foot self-care knowledge and practice among patients with diabetes attending diabetic clinic in the Gambia. Int Wound J 2024; 21:e14963. [PMID: 38989596 PMCID: PMC11237878 DOI: 10.1111/iwj.14963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024] Open
Abstract
Diabetic foot ulcer is the most common complication causing lots of admissions among diabetic patients. Understanding patients' level of foot self-care knowledge, practice and associated factors is important for planning interventions to control and prevent diabetic foot complications. This study aimed to assess the level of knowledge and practice of foot self-care among diabetic patients attending diabetic clinics in The Gambia. Two hundred and seventeen patients attending diabetic clinics in two public hospitals were selected using a successive sampling technique. Data were collected using a validated interviewer-administered questionnaire. Descriptive statistics were used to summarize the demographic and clinical data. Multivariate logistic regression was used to identify factors associated with foot self-care knowledge and practice. The findings showed a poor level of foot self-care knowledge (n = 114; 52.5%) and practice (n = 149; 68.7%). Patients' educational level was statistically significantly association with diabetic foot self-care knowledge (p = 0.02). Diabetic foot ulcer history (aOR = 0.23, 95% CI: 0.08-0.63; p < 0.001), diabetic hospitalization (aOR = 2.41, 95% CI: 1.23-4.75, p = 0.01) and diabetic foot care education (aOR = 2.65, 95% CI: 1.39-5.06, p < 0.001) were statistically significantly associated with foot self-care practice. The poor diabetic foot self-care knowledge and practice among these patients emphasize the need for a diabetic health education program in these clinics.
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Affiliation(s)
- Tobiloba Oyejide Alex Omotosho
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health ScienceUniversity of the GambiaBanjulThe Gambia
| | - Yusupha Sanyang
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health ScienceUniversity of the GambiaBanjulThe Gambia
| | - Thomas Senghore
- Department of Nursing and Reproductive Health, School of Medicine and Allied Health ScienceUniversity of the GambiaBanjulThe Gambia
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Ferreira G, Carvalho A, Pereira MG. Educational Interventions on Diabetic Foot Self-Care: A Study Protocol for a Pragmatic Randomized Controlled Trial. HEALTH COMMUNICATION 2024; 39:1383-1392. [PMID: 37204003 DOI: 10.1080/10410236.2023.2213875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Diabetic foot is one of the most serious complications of diabetes and foot ulcer recurrence has been associated with poor foot care. Educational programs may work as a vehicle for promoting knowledge and adequate foot self-care behaviors, reducing potential ulcerative complications in the diabetic foot, and promoting a better quality of life. This study protocol will analyze the impact of two different educational strategies - an instructive video (Experimental Group 1) compared to a foot care leaflet with real-time guided reading (Experimental Group 2) and standard care (Control Group) - on adherence and knowledge about diabetic foot care and patients' perception of their foot health. This study is a Pragmatic Randomized Controlled Trial of a non-pharmacological treatment. Participants need to have a diabetic foot diagnosis and attend a Diabetic Foot Multidisciplinary Consultation at two hospitals from the North of Portugal. Participants will be assessed at the first appointment of the diabetic foot consultation (T0), two weeks after (T1), and three months later, at follow-up (T2). Primary outcomes will be adherence and knowledge about diabetic foot care and general foot health. Secondary outcomes will be illness representations regarding diabetic foot. The results of this study will inform educational interventions to decrease diabetic foot ulcers, amputation rates, and the costs associated with both, contributing to foot care adherence and improve patient's quality of life.
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Affiliation(s)
- Gabriela Ferreira
- Psychology Research Centre, School of Psychology, University of Minho
| | - André Carvalho
- Service of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário do Porto
| | - M Graça Pereira
- Psychology Research Centre, School of Psychology, University of Minho
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Elafros MA, Callaghan BC, Skolarus LE, Vileikyte L, Lawrenson JG, Feldman EL. Patient and health care provider knowledge of diabetes and diabetic microvascular complications: a comprehensive literature review. Rev Endocr Metab Disord 2023; 24:221-239. [PMID: 36322296 PMCID: PMC10202021 DOI: 10.1007/s11154-022-09754-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
Diabetic retinopathy, neuropathy, and nephropathy occur in more than 50% of people with diabetes, contributing substantially to morbidity and mortality. Patient understanding of these microvascular complications is essential to ensure early recognition and treatment of these sequalae as well as associated symptoms, yet little is known about patient knowledge of microvascular sequalae. In this comprehensive literature review, we provide an overview of existing knowledge regarding patient knowledge of diabetes, retinopathy, neuropathy, and nephropathy. We also discuss health care provider's knowledge of these sequalae given that patients and providers must work together to achieve optimal care. We evaluated 281 articles on patient and provider knowledge of diabetic retinopathy, neuropathy, and nephropathy as well as predictors of improved knowledge and screening practices. Results demonstrated that patient and provider knowledge of microvascular sequalae varied widely between studies, which may reflect sociocultural or methodologic differences. Knowledge assessment instruments varied between studies with limited validation data and few studies controlled for confounding. Generally, improved patient knowledge was associated with greater formal education, longer diabetes duration, and higher socioeconomic status. Fewer studies examined provider knowledge of sequalae, yet these studies identified multiple misconceptions regarding appropriate screening practices for microvascular complications and the need to screen patients who are asymptomatic. Further investigations are needed that use well validated measures, control for confounding, and include diverse populations. Such studies will allow identification of patients and providers who would benefit from interventions to improve knowledge of microvascular complications and, ultimately, improve patient outcomes.
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Affiliation(s)
| | | | - Lesli E Skolarus
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Loretta Vileikyte
- Division of Diabetes, Endocrinology, and Gastroenterology, University of Manchester, Manchester, UK
- Department of Endocrinology and Dermatology, University of Miami, Miami, FL, USA
| | - John G Lawrenson
- School of Health and Psychological Sciences, City, University of London, London, UK
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
- Department of Neurology, Michigan Medicine, University of Michigan, 48109, Ann Arbor, MI, USA.
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Dietz CJ, Sherrill WW, Ankomah S, Rennert L, Parisi M, Stancil M. Impact of a community-based diabetes self-management support program on adult self-care behaviors. HEALTH EDUCATION RESEARCH 2023; 38:1-12. [PMID: 36367205 DOI: 10.1093/her/cyac034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Diabetes is a chronic condition that has reached epidemic proportions in the United States, affecting nearly 34 million adults, and disproportionately affecting vulnerable populations, such as ethnic minorities, the elderly and individuals with low socioeconomic status. This study addresses the impact of the Health Extension for Diabetes (HED) program, a community-based diabetes self-management support program, on adult diabetes self-care behaviors. The Summary of Diabetes Self-Care Activities (SDSCA) was utilized to evaluate improvement in diabetes self-care behaviors. Descriptive statistics, univariate and multivariable regression models were conducted. Significant increases were observed among program participants (N = 149) in all five subscales of the SDSCA (general diet, specific diet, blood glucose testing, exercise and foot care; P-values < 0.001). A priority of this diabetes education program was helping underserved populations; over half (62%) of participants self-identified as Black/African Americans. After program participation, scores on all SDSCA subscales increased significantly among Black/African Americans (n = 93) by approximately 1 day per week. White/other races (n = 56) showed similar increases in four of the SDSCA subscales post-HED program participation. This study shows that increasing participation in community-based, diabetes self-management support programs, such as HED, can increase engagement in diabetes self-care behaviors among underserved groups.
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Affiliation(s)
- C J Dietz
- Department of Public Health Sciences, Clemson University, 521 Edwards Hall, Clemson, SC 29634, USA
| | - W W Sherrill
- Department of Public Health Sciences, Clemson University, 521 Edwards Hall, Clemson, SC 29634, USA
| | - S Ankomah
- Department of Public Health Sciences, Clemson University, 521 Edwards Hall, Clemson, SC 29634, USA
| | - L Rennert
- Department of Public Health Sciences, Clemson University, 521 Edwards Hall, Clemson, SC 29634, USA
| | - M Parisi
- Cooperative Extension Service, Clemson University, 103 Barre Hall, Clemson, SC 29634, USA
| | - M Stancil
- Diabetes Self-Management Program, Prisma Health-Upstate, 875 W Faris Rd, Greenville, SC 29605, USA
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Jia H, Wang X, Cheng J. Knowledge, Attitudes, and Practices Associated With Diabetic Foot Prevention Among Rural Adults With Diabetes in North China. Front Public Health 2022; 10:876105. [PMID: 35669753 PMCID: PMC9163951 DOI: 10.3389/fpubh.2022.876105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background The diabetic foot is a global threat to public health because it can result in infection and amputation, as well as cause the patient to experience considerable pain and incur financial costs. The condition of patients with diabetic foot in North China is distinguished by more severe local ulcers, a worse prognosis, and a longer duration of disease than that of patients with diabetic foot in the south. Through appropriate preventive measures, the diabetic foot can be effectively avoided. This study assesses the existing knowledge, attitudes and practices associated with diabetic foot prevention among adults with diabetes living in rural areas of North China. Method This cross-sectional survey included 1,080 rural adults from North China, cluster sampled 12 villages and surveyed diabetic patients without diabetic foot who participated in community diabetes management. The self-administered knowledge and attitude questionnaire and the Chinese version of the Nottingham Assessment of Functional Foot-care Questionnaire were used. Result Of the 1,080 subjects, 51.6% received moderate knowledge scores, 63.9% had a positive attitude and 71.4% received poor practice scores. In terms of knowledge, parameters of knowledge about foot examinations and treatment of foot problems showed the lowest scores. In terms of practice, in line with the results of the low knowledge score, parameters of the pursuit of medical treatment for foot problems and routine foot examinations were associated with the lowest scores. Multiple regression analysis revealed that participants who were current smokers (β: -0.049, 95% CI: -0.088 to -0.011) had lower knowledge scores than those who never smoke; participants who were current smokers (β: -0.818, 95% CI: -1.067 to -0.569) and past smokers (β: -0.299, 95% CI: -0.485 to -0.112) had lower attitude scores than those who had never smoked; participants who had higher knowledge scores (β: 1.964, 95% CI: 1.572-2.356) achieved higher scores on attitudes; women had better practice scores than men (β: 0.180, 95% CI: 0.122-0.239); patients with a long diabetes duration (6-10 years) had better practice scores than those who had a short diabetes duration (<2 years; β: 0.072, 95% CI: 0.012-0.131). Knowledge (β: 0.130, 95% CI: 0.001-0.258) and attitudes (β: 0.268, 95% CI: 0.249-0.287) were significantly associated with good practices. Conclusions Increasing knowledge regarding diabetic foot would help instill positive attitudes and cultivate better practices toward diabetic foot prevention. The results of this study may help guide future promotional resources to those groups most in need, which may help lower the incidence of diabetic foot among adults in North China.
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Affiliation(s)
- Huimin Jia
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xiaocheng Wang
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jingmin Cheng
- School of Management, Shanxi Medical University, Taiyuan, China
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Validity and reliability of the German translation of the Diabetes Foot Self-Care Behavior Scale (DFSBS-D). PLoS One 2022; 17:e0269395. [PMID: 35657819 PMCID: PMC9165872 DOI: 10.1371/journal.pone.0269395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Comprehensive regular foot self-care is one of the most critical self-management behaviors for people with diabetes to prevent foot ulcer development and related complications. Yet, adequate foot self-care is only practiced by very few of those affected. To improve diabetic foot syndrome prevention, a valid and reliable instrument for measuring daily foot-care routines in patients with diabetes is needed. However, no such instrument is currently available in the German language. This study, therefore, aims to translate and cross-culturally adapt the "Diabetic Foot Self-Care Behavior Scale" (DFSBS) into German (DFSBS-D) and evaluate its validity and reliability. Material and methods The DFSBS was translated from English into German using a forward-backward procedure as per previous recommendations. Factor analysis was used to study structural validity. To establish construct validity, 21 a priori hypotheses were defined regarding the expected correlation between scores on the new German version (i.e., DFSBS-D) and those of the following questionnaires measuring related constructs: (1) German version "Diabetes Self-Care Activities Measure" (SDSCA-G), (2) "Frankfurter Catalogue of Foot Self-Care" (FCFSP), and (3) "Short Form 36" (SF-36) and tested in 82 patients. To assess test-retest reliability, patients completed the DFSBS-D again after a 2-week interval. Test-retest reliability was assessed from stable patients’ data (n = 48) by calculating two-way random-effects absolute agreement ICCs with 95% CI and Bland and Altman analyses. In addition, Cronbach’s alpha was calculated as internal consistency measure. Results The 7-item DFSBS-D showed good structural validity. Its single factor explains 57% of the total sample variance. Of the 21 predefined hypotheses, 13 (62%) were confirmed. The DFSBS-D’s internal consistency was good (Cronbach’s alpha = 0.87). Test-retest reliability over a 2-week interval was also good (ICC 0.76). Conclusion The DFSBS was successfully translated into German. Statistical analyses showed good DFSBS-D structural validity, test-retest reliability, and internal consistency. Yet, construct validity may be debated.
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Mekonen EG, Gebeyehu Demssie T. Preventive foot self-care practice and associated factors among diabetic patients attending the university of Gondar comprehensive specialized referral hospital, Northwest Ethiopia, 2021. BMC Endocr Disord 2022; 22:124. [PMID: 35546665 PMCID: PMC9097232 DOI: 10.1186/s12902-022-01044-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Diabetes mellitus is emerging as a major worldwide health problem that has a social, financial, and developmental impact on developing countries. Foot complications are among the most serious and costly complications of diabetes which lead to lower extremity amputation due to diabetic foot ulcers. Poor diabetic foot self-care practice is identified by different studies as a major contributing factor to diabetic foot ulcers. Therefore, this study was intended to assess foot self-care practice and associated factors among diabetic patients attending the University of Gondar comprehensive specialized referral hospital. METHODS A hospital-based cross-sectional study was conducted from July 1 to August 30, 2021, at the University of Gondar comprehensive specialized referral hospital. A systematic random sampling technique was employed to select 384 diabetic patients. A structured pretested interviewer-administered questionnaire was used to collect data. The data was entered in epi-info version 7, analyzed using SPSS version 21, and presented using frequencies, percentages, tables, and graphs. Bivariable and multivariable analyses were investigated using a binary logistic regression model. P-value < 0.05 and an odds ratio with a 95% confidence interval were used to determine the significance and strength of the association. RESULTS Of the 384 diabetic patients, 46.4% (95% CI (41.1%-51.6%)) of them had poor foot self-care practice. Being male [AOR = 0.54, 95% CI (0.32, 0.89)], couldn't read and write and completed primary education [AOR = 2.35, 95% CI (1.01, 5.43)] & [AOR = 2.92, 95% CI (1.39, 6.12)], living in rural area [AOR = 3.84, 95% CI (1.91, 7.75)], having diabetic complications [AOR = 2.19, 95% CI (1.07, 4.46)], taking both injection and pills [AOR = 0.33, 95% CI (0.12, 0.88)], having previous information about foot care [AOR = 0.12, 95% CI (0.06, 0.24)], and family support [AOR = 0.57, 95% CI (0.34, 0.94)] were determinants of poor foot self-care practice. CONCLUSION The adherence of diabetic patients toward foot self-care practice was poor. Being male, having low educational status, living in a rural area, having diabetic-related complications, taking both injections and pills, not having previous information about foot care, and having poor family support increases the odds of having poor foot self-care practice. Giving health education to patients and their caregivers about the basic principles of diabetes foot care, like regular inspection of feet and appropriate footwear at their regular follow-up time, should be emphasized.
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Affiliation(s)
- Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tizita Gebeyehu Demssie
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kes D, Sahin F, Ertinmaz Ozkan A, Erem Basmaz S. Effectiveness of a Transtheoretical Model-Based Foot Care Program in Improving Foot Care Behaviors and Self-Efficacy in Adults With Type 2 Diabetes: An Assessor-Blinded Randomized Controlled Trial. Res Theory Nurs Pract 2022; 36:3-19. [PMID: 35173025 DOI: 10.1891/rtnp-d-21-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to evaluate the effects of a transtheoretical model (TTM)-based foot care program on foot self-care behaviors and self-efficacy among adults with type 2 diabetes (T2DM). A prospective, assessor-blinded, randomized controlled trial was conducted between January 2020 and October 2020 at the endocrinology outpatient unit of a hospital in the north-west Turkey. The sample was composed of 51 adults with T2DM randomly allocated to the intervention group (n = 25) and control group (n = 26). The intervention group received the TTM-based foot care program during a 6-month period. The data were analyzed using the two-way repeated measure analysis of variance (ANOVA). After intervention, the intervention group's the diabetic foot care self-efficacy scale scores increased significantly at 3 and 6 months, compared with the control group. Similarly, the intervention group's the foot self-care behavior scale scores also increased significantly at 3 months and 6 months.
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Affiliation(s)
- Duygu Kes
- Nursing Department, Karabuk University, Karabuk, Turkey
| | - Fatime Sahin
- Karabuk Training and Research Hospital, Karabuk University, Karabuk, Turkey
| | | | - Seda Erem Basmaz
- Department of Endocrinology and Metabolism, Karabuk University, Karabuk, Turkey
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Exploring the Relationship of Health Beliefs and Self-Care Behaviors Related to Diabetic Foot Ulcers of Type II Diabetes Mellitus Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137207. [PMID: 34281144 PMCID: PMC8296960 DOI: 10.3390/ijerph18137207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022]
Abstract
Objective: Diabetic foot ulcers are an invasive complication of diabetes and are increasing. This study investigates the relationship between health beliefs and foot self-care behaviors, among people with type II diabetes. Methods: A cross-sectional design was adopted, and 98 patients were recruited from outpatient clinics of the endocrine department. The questionnaires of Demographic, Diabetes Foot Ulcer Health Belief Scale (Health Beliefs, DFUHBS), and Diabetes Foot Self-Care Behavior Scale (Self Care, DFSBS) were used to collect data. Results: Among the subjects living alone or who had diabetes less than ten years, the score of DFSBS was significantly lower than among those living with families or who had diabetes for ten years or more. The frequency of performing diabetes foot self-care behavior, among males was lower than among females significantly. Although there was no significant difference in the Health Belief total score, there were differences in the benefit subscale. Those who had junior high school level or less or had diabetes less than ten years, their score was significantly lower than those with senior high school level or more or had diabetes ten years or more. In a multivariable regression model, living with family, diabetes duration, and health beliefs explained 42.9% of the variance of diabetic-foot self-care behaviors. Conclusions: Living alone, shorter duration of diabetes, male gender, and lower health belief scores predict less adequate diabetic foot self-care behavior. Health care providers should assess these factors when designing individual care plans.
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Mahmoodi H, Abdi K, Navarro-Flores E, Karimi Z, Sharif Nia H, Gheshlagh RG. Psychometric evaluation of the Persian version of the diabetic foot self-care questionnaire in Iranian patients with diabetes. BMC Endocr Disord 2021; 21:72. [PMID: 33865367 PMCID: PMC8052781 DOI: 10.1186/s12902-021-00734-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Diabetic foot self-care refers to a group of self-management behaviors that can reduce the incidence of foot ulcers and amputations. It is necessary to have a valid and reliable standard tool to measure foot self-care in diabetic patients. This study aimed to evaluate the psychometric properties of the Persian version of the Diabetic Foot Self-Care Questionnaire of the University of Malaga, Spain (DFSQ-UMA) in Iran. METHODS This cross-sectional study was conducted with 407 diabetic patients who were selected using a convenient sampling method. Construct validity was assessed by exploratory (with 207 patients) and confirmatory (with 200 patients) factor analyses. Internal consistency was calculated using Cronbach's alpha and McDonald's omega coefficients. RESULTS In the exploratory factor analysis, three factors with eigenvalues of 3.84, 2.41, and 2.26 were extracted that together explained 56.74% of the total variance of diabetic foot self-care. A Cronbach's alpha of 0.865 was found for the total instrument. CONCLUSIONS The Persian version of the DFSQ-UMA has good validity and reliability, and given its good psychometric properties, it can be used in future studies.
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Affiliation(s)
- Hassan Mahmoodi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kamel Abdi
- Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulaymaniyah, Kurdistan Region Iraq
| | - Emmanuel Navarro-Flores
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Málaga, Spain
| | - Zaniar Karimi
- Faculty of Nursing, Kurdistan University of Medical Sciences, Sananda, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Świątoniowska N, Chabowski M, Jankowska-Polańska B. Quality of Foot Care Among Patients With Diabetes: A Study Using a Polish Version of the Diabetes Foot Disease and Foot Care Questionnaire. J Foot Ankle Surg 2021; 59:231-238. [PMID: 31932159 DOI: 10.1053/j.jfas.2019.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/29/2019] [Indexed: 02/03/2023]
Abstract
Diabetic foot syndrome is a common, yet serious complication of diabetes, affecting 4% to 10% of patients with diabetes. Polish Diabetes Association guidelines emphasize the need for prevention among patients with diabetes; a key role is played by consistent education on foot care and ulceration prevention. The Diabetes Foot Disease and Foot Care Questionnaire (DFDFC-Q) is the only research instrument available for comprehensive assessment of foot self-care. The study purposes were to explore the quality of foot care among patients with diabetes and to evaluate the psychometric properties of the Polish version of the DFDFC-Q in adult patients with diabetes. The study included 180 patients (112 females and 68 males, mean age 62 ± 14.1 years) with clinically confirmed diabetes mellitus and was performed between January 2017 and May 2018. The questionnaire was translated into Polis, and evaluated by using Cronbach's α coefficient. Of the 180 patients, 39.7% demonstrated good quality of self-care, 44.7% demonstrated moderate quality, and 15.6% demonstrated low quality. Mean score in the group was 22 ± 4.18 points. Scale reliability as measured by Cronbach's α was 0.672. One hundred thirteen (62.78%) patients inspected their feet daily. Many patients wore improper footwear: flip-flops (69.44%) or sandals (58.89%). The aspect most commonly omitted in diabetes education was inspection of the soles of one's feet using a mirror (17.7%). We found that 16.1% of patients visited a podologist in the past year. Comparative analysis demonstrated that a good-quality foot self-care was associated with high school education (p = .008), not having a partner (p = .046), and adhering to dietary recommendations (p = .014). In the linear regression model, independent predictors of better foot self-care included high school and vocational education (β = 7.439, p = .001 and β = 5.539, p = .014, respectively), marital status (divorced and single: β = 3.496, p = .025, widowed: β = 3.466, p = .048), professional inactivity (retirees: β = 7.679, p = .001; disability pensioners: β = 3.522, p = .049; unemployed: β = 4.631, p = .017), and adhering to a diet (β = 5.065, p = .001). An independent negative predictor (i.e., one associated with lower scores in the questionnaire) was male sex (β = -2.853, p = .024). The Polish version of the DFDFC-Q has moderate psychometric properties, but because of the lack of other available instruments for foot self-care assessment, it can be used in the population of Polish diabetic patients. Better quality of foot self-care is determined by high school education, marital status (not having a partner), and adhering to dietary treatment recommendations.
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Affiliation(s)
- Natalia Świątoniowska
- Doctoral Student and Registered Nurse, Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Mariusz Chabowski
- Associate Professor and Surgeon, Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland; Professor, Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland.
| | - Beata Jankowska-Polańska
- Doctoral Student and Registered Nurse, Division of Nursing in Internal Medicine, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Wolderufael M, Dereje N. Self-Care Practice and Associated Factors Among People Living with Type 2 Diabetes in Addis Ababa, Ethiopia: A Facility-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:1-9. [PMID: 33442277 PMCID: PMC7797280 DOI: 10.2147/dmso.s287352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/04/2020] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Diabetes is a global public health threat with a considerably high burden in low- and middle-income countries. The application of self-care practice by people living with diabetes helps to manage diabetes and its complications, and to lengthen their life. However, the level of diabetes self-care practice in Ethiopia is very low. METHODS A cross-sectional study was conducted among people living with type 2 diabetes who were on follow-up from January 01 to 31, 2019 at Yekatit 12 Hospital. A systematic sampling technique was employed to recruit 354 study participants. A face-to-face interview was administered by trained data collectors using a structured questionnaire. Diabetes self-care practice was assessed by using Summary of Diabetes Self-Care Activities (SDSCA) scale. Multi-variable binary logistic regression analysis was carried out to identify factors associated with diabetes self-care practice. RESULTS More than half (52.0%, 95% CI: 49.9% - 57.1%) of the people living with diabetes had poor diabetes self-care practice. Poor self-care practice was associated with being unemployed and retired (AOR= 3.57, 95% CI 1.65-7.72), having diabetes for ≥10 years (AOR= 1.78, 95% CI 1.07-2.95), having comorbidity (AOR= 2.15, 95% CI 1.35-3.43), not owning glucometer (AOR= 1.81, 95% CI 1.16-2.83), not receiving diabetes education (AOR= 1.95, 95% CI 1.20-3.18) and dissatisfaction with social support (AOR= 4.24, 95% CI 1.25-14.40). CONCLUSION Poor self-care practice was found to be substantial among people living with diabetes in Addis Ababa, with self-monitoring of blood glucose and regular exercise being the least performed. It is beneficial to focus more on lifestyle modifications and educating about the severity of the disease for better management of blood sugar levels and hindrance of complications.
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Affiliation(s)
- Meklit Wolderufael
- Department of Medicine, Myungsung Medical College, Addis Ababa, Ethiopia
| | - Nebiyu Dereje
- Department of Public Health, Myungsung Medical College, Addis Ababa, Ethiopia
- Correspondence: Nebiyu Dereje Department of Public Health, Myungsung Medical College, Addis Ababa14972, EthiopiaTel +251978788638 Email
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Hirpha N, Tatiparthi R, Mulugeta T. Diabetic Foot Self-Care Practices Among Adult Diabetic Patients: A Descriptive Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:4779-4786. [PMID: 33304103 PMCID: PMC7723031 DOI: 10.2147/dmso.s285929] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/23/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Adequate foot care and regular foot examinations along with optimal glycemic control are effective strategies to prevent foot ulceration. AIM The aim of this study was to describe the patterns of foot self-care practice among diabetic patients attending an ambulatory clinic. METHODS A descriptive cross-sectional study was conducted at the ambulatory clinic of Jimma Medical Center. A consecutive sampling technique was used. The data were analyzed by SPSS version 20 and descriptive statistics were used to describe the findings. RESULTS A total of 370 diabetic patients (55.9% male and 68.4% type 2) were interviewed. The mean (±SD) age of the patients was 46.47±13.63 years. Over one-third (35.7%) of the patients had a previous history of foot ulcer. The majority of the patients self-inspect (92.5%) and wash (82.7%) their foot at least daily, respectively. In this study, 12.2% of the patients never inspected the inside of their footwear before putting them on and 42.4% of the patients never dry between their toes after washing. Most (63.5%) of patients never used moisturizing creams to lubricate the dry skin. In this study, 23.0% and 27.6% of the patients walk in sandals/slippers and in shoes without socks most of the time, respectively. Only 27.3% of the patients changed their socks daily. Majority (78.4% and 86.5%) of the patients never walk barefoot around and outside their house, respectively, and 75.1% of the patients never put their feet near the fire. CONCLUSION Diabetic patients were not adequately self-inspect and wash their foot at least daily, dry after wash and moisturize the dry skin. They walk barefoot, in sandals/slippers, and in shoes without socks. Therefore, clinicians should counsel every diabetic patient about the importance of foot self-inspection, foot hygiene, and the risk of walking barefoot, wearing sandals/slippers, and shoes without socks at every follow-up visit.
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Affiliation(s)
- Namo Hirpha
- Department Hospital Pharmacy, Bako Primary Hospital, West Shewa, Oromia, Ethiopia
| | - Ramanjireddy Tatiparthi
- Institute of Health, School of Pharmacy, Department of Pharmaceutics, Jimma University, Jimma, Oromia, Ethiopia
| | - Temesgen Mulugeta
- Institute of Health, School of Pharmacy, Department of Clinical Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
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Hasanpour Dehkordi A, Chin YF, Huang TT, Ebadi A, Ghanei Gheshlagh R. Psychometric evaluation of the Farsi version of the diabetes foot self-care bahavior scale. J Foot Ankle Res 2020; 13:68. [PMID: 33256822 PMCID: PMC7708251 DOI: 10.1186/s13047-020-00437-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/23/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diabetes foot self-care is one of the self-management behaviors of diabetic patients leading to a reduction in the incidence of pressure ulcers and amputation. Having a valid, reliable, simple and comprehensive tool is essential in measuring the self-care behavior of diabetic patients. The aim of this study was to evaluate the psychometric properties of the Farsi version of the diabetes foot self-care bahavior scale (DFSBS) in Iran. METHODS In this cross-sectional and methodological study, 500 patients with type 2 diabetes were recruited by convenience sampling. Construct validity was assessed by exploratory factor analysis (over 300 patients) and confirmatory factor analysis (over 200 patients). Internal consistency was calculated by Cronbach's alpha coefficient and its stability was calculated by intraclass correlation coefficient (ICC). RESULTS In the exploratory factor analysis, two self-care factors related to feet and shoes were extracted which had specific values of 38.49 and 1.24, respectively, and were able to account for 56.22% of the total self-care variance of diabetes foot. Confirmatory factor analysis had excellent fit model. The internal consistency and ICC of the whole instrument were 0.83 and 0.791 (95% CI: 0.575-0.925; P < 0.001), respectively. CONCLUSIONS The Farsi version of DFSBS (F-DFSBS) has good validity and reliability, and due to its appropriate psychometric properties, this tool can be used in future studies.
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Affiliation(s)
- Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Yen-Fan Chin
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzu-Ting Huang
- Healthy Aging Research Center, and School of Nursing, Chang Gung University, Taoyuan City, Taiwan
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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15
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Littman AJ, Knott CJ, Boyko EJ, Hawes SE. Associations Between Racial and Ethnic Groups and Foot Self-Inspection in People With Diabetes. Diabetes Care 2020; 43:956-963. [PMID: 32132006 PMCID: PMC7809712 DOI: 10.2337/dc19-1486] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/28/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Daily foot self-inspection may permit earlier detection and treatment of a foot lesion, reducing the risk of infection and lower-limb amputation (LLA). Though race and ethnicity are strongly associated with LLA risk, with higher risk seen in African Americans (AA), American Indians/Alaska Natives (AI/AN), and Native Hawaiians/Pacific Islanders (NH/PI), associations between foot self-inspection and racial and ethnic groups are inconsistent. We aimed to assess differences in foot self-inspection among people with diabetes by race/ethnicity. RESEARCH DESIGN AND METHODS Using national, cross-sectional data from the 2015-2017 Behavioral Risk Factor Surveillance System surveys and including 88,424 individuals with diabetes, we estimated prevalence ratios (PRs) and associated 95% CIs of daily foot checking for sores or irritation by racial and ethnic groups using log-binomial linear regression models, after accounting for survey weights. RESULTS Compared with whites (who had a weighted prevalence [P] of daily foot self-inspection of 57%), AA (P 67%, PR 1.18 [95% CI 1.14, 1.23]), AI/AN (P 66%, PR 1.15 [95% CI 1.07, 1.25]), and NH/PI (P 71%, PR 1.25 [95% CI 1.03, 1.52]) had higher prevalences of daily foot self-inspection. The prevalence of daily foot inspection was significantly lower among Asians (P 35%, PR 0.62 [95% CI 0.48, 0.81]) and Hispanics (P 53%, PR 0.93 [95% CI 0.88, 0.99]) compared with whites. Associations did not vary importantly by insulin use, years since diabetes diagnosis, or having received diabetes self-management education. CONCLUSIONS The higher frequency of foot self-inspection in racial and ethnic groups at elevated risk of diabetes-related LLA is not sufficient to eliminate LLA disparities; additional interventions are needed to achieve this aim.
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Affiliation(s)
- Alyson J Littman
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA .,Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research and Development, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Catherine J Knott
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
| | - Edward J Boyko
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA.,Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
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16
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Pourkazemi A, Ghanbari A, Khojamli M, Balo H, Hemmati H, Jafaryparvar Z, Motamed B. Diabetic foot care: knowledge and practice. BMC Endocr Disord 2020; 20:40. [PMID: 32192488 PMCID: PMC7083045 DOI: 10.1186/s12902-020-0512-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 02/25/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diabetic foot ulcers (DFUs) are common problems in diabetes. One of the most important factors affecting the quality of diabetes care is knowledge and practice. The current study aimed at determining the knowledge and practice of patients with diabetes regarding the prevention and care of DFUs. METHODS The current analytical, cross sectional study was conducted in Guilan Province (north of Iran) on 375 patients registered in the medical records as type 2 diabetes mellitus. Demographic characteristics, knowledge, and practice of participants were recorded in a questionnaire during face-to-face interviews conducted by the researcher. Descriptive and inferential statistics were performed using SPSS version18. RESULTS The mean score of knowledge was 8.63 ± 2.5 out of 15, indicating that the majority of participants had a poor knowledge (84.8%). The mean practice score was 7.6 ± 2.5 out of 15, indicating that a half of them had poor performance (49.6%). There was a significant and direct correlation between knowledge and practice. Knowledge level, place of residence, marital status, and history of admission due to diabetic foot were predictors of practice score. CONCLUSIONS According to the low level of knowledge and practice in patients with diabetes regarding the prevention and care of DFUs, and considering the significant relationship of some demographics of patients with knowledge and practice scores, a targeted educational program is needed to promote knowledge of patients with diabetes.
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Affiliation(s)
- Aydin Pourkazemi
- Razi Clinical Research Development unit, Guilan university of medical sciences, Rasht, Iran
| | - Atefeh Ghanbari
- Social Determinants of Health Research center, nursing and midwifery school, Guilan University of medical sciences, Rasht, Iran
| | - Monireh Khojamli
- Razi Clinical Research Development unit, Guilan university of medical sciences, Rasht, Iran
| | - Heydarali Balo
- Razi Clinical Research Development unit, Guilan university of medical sciences, Rasht, Iran
| | - Hossein Hemmati
- Razi Clinical Research Development unit, Guilan university of medical sciences, Rasht, Iran
| | - Zakiyeh Jafaryparvar
- Razi Clinical Research Development unit, Guilan university of medical sciences, Rasht, Iran
| | - Behrang Motamed
- Department of internal medicine , Razi Hospital ,School of Medicine, Guilan university of Medical Sciences, Rasht, Iran
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17
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Khan L, Al-Nami A, Al-Gaseer H, Al-Neami I. Foot self-care knowledge and practice evaluation among patients with diabetes. JOURNAL OF DIABETOLOGY 2020. [DOI: 10.4103/jod.jod_30_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Rasoul AM, Jalali R, Abdi A, Salari N, Rahimi M, Mohammadi M. The effect of self-management education through weblogs on the quality of life of diabetic patients. BMC Med Inform Decis Mak 2019; 19:205. [PMID: 31665001 PMCID: PMC6819410 DOI: 10.1186/s12911-019-0941-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/16/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Self-management education of diabetes which is one of the most important noncommunicable diseases worldwide involves facilitating knowledge, skills, and ability required for self-care in these patients. Concerning the progressive growth of use of Internet for educating patients and absence of different studies about education through use of weblogs in patients with diabetes in Iran, the present study was conducted with the aim of determining the effect of self-management education through weblogs on the quality of life of affect the patients. METHODS This study was performed as intervention on patients referring to diabetes clinic of Talghani hospital in Kermanshah in winter 2018 and spring 2019. The samples consisted of 98 patients with diabetes chosen through available sampling and randomly assigned into study and control groups. For data collection, diabetes quality of life (DQOL) short form clinical questionnaire, Persian version, was used. The intervention involved training self-management conducted through 60 sessions via a designed weblog. The obtained information was introduced into SPSS 21, and analyzed through Mann-Whitney, t-test, and paired t-test. RESULTS According to the results of this study, the mean age of the examined patients was 32.1 ± 4.9 years, where the major participants were male (n = 52 in the test group, 52.5%). The results showed that after the intervention, the test and control groups were different in terms of anthropometric variables and metabolic indicators; the mean waist circumference in the test and control groups was 98.6 ± 9.8 and 101.5 ± 7.8, respectively; the mean FBS following the intervention in the test and control groups was 131.08 ± 16.04 and 238.2 ± 40, respectively; and the mean BMI postintervention in the test and control groups was obtained as 27.3 ± 3.4 and 30.1 ± 3.8 respectively, where these differences were significant according to independent t-test (p < 0.05). The mean score of quality of life postintervention in the test and control groups was obtained as 56.1 and 49.9 respectively; according to Mann-Whitney test, the difference between the two groups was significant (p < 0.05). CONCLUSION The results of the present study revealed the positive effect of weblog based self-management on the quality of life of patients with diabetes following the intervention. Further, reduced levels of FBS, BMI, as well as systolic and diastolic blood pressure were also observed, which could be due to increased awareness of patients about their abilities, its risks, as well as the ways to control and treat it.
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Affiliation(s)
- Amal Mohammad Rasoul
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehrali Rahimi
- Diabetes Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Valizadeh R, Vali L, Bahaadinbeigy K, Amiresmaili M. The Challenges of Iran's Type 2 Diabetes Prevention and Control Program. Int J Prev Med 2019; 10:175. [PMID: 32133093 PMCID: PMC6826765 DOI: 10.4103/ijpvm.ijpvm_371_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/13/2017] [Indexed: 11/29/2022] Open
Abstract
Background: Incidence and prevalence of type 2 diabetes are one of the major challenges of Iran health system. Despite policies on diabetes prevention and control, Iran is faced with many problems in prevention and control of this disease at the executive level. This study seeks to identify the problems of Type 2 diabetes prevention and control program in Iran. Methods: In this qualitative study, 17 participants were interviewed purposefully. The semi-structured interview guide was designed based on literature review and four initial in-depth interviews. Framework analysis method was used for the analysis of qualitative data. Results: Six themes and 29 subthemes explaining the problems of type 2 diabetes prevention and control program were identified: Referral system, human resources, infrastructure, cultural problems, access, and intersectoral coordination issues. Conclusions: Despite the well-developed policy of type 2 diabetes prevention and control, the implementation is faced with some problems which endangers the effectiveness of the plan. Any attempt to improve the successful implementation of the type 2 diabetes prevention and control program requires effective measures, deep understanding of the problems and solving them.
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Affiliation(s)
- Reza Valizadeh
- Department of health management, policy and economics, school of management and medical informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Vali
- Environmental Health Engineering Research center, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Department of health management, policy and economics, school of management and medical informatics, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammadreza Amiresmaili
- Department of health management, policy and economics, school of management and medical informatics, Kerman University of Medical Sciences, Kerman, Iran
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20
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Mogre V, Johnson NA, Tzelepis F, Shaw JE, Paul C. A systematic review of adherence to diabetes self‐care behaviours: Evidence from low‐ and middle‐income countries. J Adv Nurs 2019; 75:3374-3389. [DOI: 10.1111/jan.14190] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/20/2019] [Accepted: 08/05/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Victor Mogre
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Department of Health Professions Education School of Medicine and Health Sciences University for Development Studies Tamale Ghana
| | - Natalie A. Johnson
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
| | - Flora Tzelepis
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
- Hunter New England Population Health Hunter New England Local Health District Wallsend New South Wales Australia
| | | | - Christine Paul
- School of Medicine and Public Health University of Newcastle Callaghan New South Wales Australia
- Hunter Medical Research Institute New Lambton New South Wales Australia
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21
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Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self-care: A qualitative study of patients' and healthcare providers' perspectives. J Clin Nurs 2019; 28:2296-2308. [PMID: 30791160 DOI: 10.1111/jocn.14835] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/15/2019] [Accepted: 02/12/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore patient and healthcare provider (HCP) perspectives about patients' barriers to the performance of diabetic self-care behaviours in Ghana. BACKGROUND Sub-Saharan African urban populations are increasingly affected by type 2 diabetes due to nutrition transition, sedentary lifestyles and ageing. Diabetic self-care is critical to improving clinical outcomes. However, little is known about barriers to diabetic self-care (diet, exercise, medication taking, self-monitoring of blood glucose and foot care) in sub-Saharan Africa. DESIGN Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. METHODS Semi-structured interviews were conducted among 23 people living with type 2 diabetes and 14 HCPs recruited from the diabetes clinics of three hospitals in Tamale, Ghana. Interviews were audiotaped and transcribed verbatim. The constant comparative method of data analysis was used and identified themes classified according to constructs of the theory of planned behaviour (TPB): attitudes/behavioural beliefs, subjective norms and perceived behavioural control. RESULTS Barriers relating to attitudes included misconceptions that diabetes was caused by spiritual forces or curses, use of herbal medicines, intentional nonadherence, difficulty changing old habits, and feeling or lacking motivation to exercise. Barriers relating to subjective norms were inadequate family support, social stigma (usually by spouses and other members of the community) and cultural beliefs. Perceived behavioural control barriers were poor income levels, lack of glucometers, busy work schedules, long distance to the hospital and inadequate access to variety of foods due to erratic supply of foods or seasonality. CONCLUSIONS Both patients and HCPs discussed similar barriers and those relating to attitude and behavioural control were commonly discussed. RELEVANCE TO CLINICAL PRACTICE Interventions to improve adherence to diabetic self-care should focus on helping persons with diabetes develop favourable attitudes and how to overcome behavioural control barriers. Such interventions should have both individualised and community-wide approaches.
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Affiliation(s)
- Victor Mogre
- Department of Health Professions Education and Innovative Learning, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana.,School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Natalie A Johnson
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton, New South Wales, Australia
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Yıldırım Usta Y, Dikmen Y, Yorgun S, Berdo İ. Predictors of foot care behaviours in patients with diabetes in Turkey. PeerJ 2019; 7:e6416. [PMID: 30775183 PMCID: PMC6369832 DOI: 10.7717/peerj.6416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 01/09/2019] [Indexed: 01/16/2023] Open
Abstract
Background The management of diabetic foot complications is challenging, time-consuming and costly. Such complications frequently recur, and the feet of individuals with diabetes can be easily infected. The variables that predict foot care behaviours must be identified to improve foot care attitudes and behaviours. Thus, this study aimed to evaluate the predictors of foot care behaviours in individuals with diabetes and the role of these variables. Methods This descriptive and analytic study was carried out between July 2015 and July 2016, and 368 outpatients with diabetes from a public hospital in Turkey were included. The participants had no communication, psychiatric or neurological problems and had been diagnosed with diabetes for at least 1 year. Foot care behaviour was the dependent variable and was evaluated with the foot care behaviour questionnaire. The relationship among foot care behaviours and sociodemographic characteristics, diabetes-related attitudes, disease perception, health beliefs and perceived social support was evaluated. Factors that independently predicted effective foot care behaviours were estimated via a linear regression analysis. Results The foot care behaviour score of the participants was above average (54.8 ± 5.0). Gender (t = −2.38, p = 0.018), history of a foot wound (t = −2.74, p = 0.006), nephropathy (t = 3.13, p = 0.002), duration subscale of the illness perception scores (t = 2.26, p = 0.024) and personal control subscale of the health belief scores (t = −2.07, p = 0.038) were significant predictors of foot care behaviours. These variables, which provided model compatibility, accounted for approximately 22.0% of the total variance of the foot care behaviour score (R = 0.47, R2 = 0.22, F = 5.48, p ≤ 0.001). Discussion Our results show factors that may affect diabetic foot care behaviours. Several of these factors prevent individuals from practising these behaviours. Further studies on the roles of barriers as predictors of foot care behaviours must be conducted.
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Affiliation(s)
| | - Yurdanur Dikmen
- Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | | | - İkbal Berdo
- Izzet Baysal Education and Research Hospital, Bolu, Turkey
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Coffey L, Mahon C, Gallagher P. Perceptions and experiences of diabetic foot ulceration and foot care in people with diabetes: A qualitative meta-synthesis. Int Wound J 2018; 16:183-210. [PMID: 30393976 DOI: 10.1111/iwj.13010] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/16/2018] [Indexed: 01/22/2023] Open
Abstract
Diabetic foot ulceration (DFU) is a common and debilitating complication of diabetes that is preventable through active engagement in appropriate foot-related behaviours, yet many individuals with diabetes do not adhere to foot care recommendations. The aim of this paper was to synthesise the findings of qualitative papers exploring diabetic people's perceptions and experiences of DFU in order to identify how they could be better supported to prevent ulceration or manage its impact. Five databases (MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science) were searched in May 2016 to identify eligible articles. Findings were synthesised using a meta-ethnographic approach. Forty-two articles were eligible for inclusion. Synthesis resulted in the development of five overarching themes: personal understandings of diabetic foot ulceration; preventing diabetic foot ulceration: knowledge, attitudes, and behaviours; views on health care experiences; development of diabetic foot ulceration and actions taken; and wide-ranging impacts of diabetic foot ulceration. The findings highlight various barriers and facilitators of foot care experienced by people with diabetes and demonstrate the significant consequences of ulcers for their physical, social, and psychological well-being. The insights provided could inform the development of interventions to promote foot care effectively and provide appropriate support to those living with ulceration.
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Affiliation(s)
- Laura Coffey
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Conor Mahon
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Pamela Gallagher
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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Gharaibeh B, Tawalbeh LI. Diabetes self-care management practices among insulin-taking patients. J Res Nurs 2018; 23:553-565. [PMID: 34394473 DOI: 10.1177/1744987118782311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Diabetes self-care management (DSCM) is complex because various factors and relationships influence its processes. Aims This study aimed to identify the level of DSCM, compare the levels of self care between patients with type 1 and patients with type 2 diabetes, and identify significant predictors of self-care among Jordanian patients with type 1 and type 2 diabetes who were taking insulin. Methods A descriptive cross-sectional design was employed using a convenience sample of 310 Jordanian patients. The Arabic translated version of the 40-item Diabetes Self-Management Scale was used to collect data. Results The type of diabetes (t(310) = 4.81; p < .001) and the type of medications (insulin, or insulin and tablets) (t(310) = 4.75; p < .001) significantly affected the level of self-care. Age (t(296) = - 3.41; p = 0.001), gender (t(296) = -4.78; p < 0.001) training in self-care (t(296) = 4.30; p < .001), educational level (t(296) = 2.81, P = .005) and using traditional treatment (herbal therapy) (t(296) = -4.64, p < .001) significantly predicted self-care and explained around 58% of the variance in self-care. Conclusions Various factors were found to influence self-care. Further research is needed to explore the complex nature of DSCM.
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Affiliation(s)
- Besher Gharaibeh
- Assistant Professor, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Loai Issa Tawalbeh
- Associate Professor, Faculty of Nursing, Al-AlBayt University, Al-Mafraq, Jordan
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Shabibi P, Zavareh MSA, Sayehmiri K, Qorbani M, Safari O, Rastegarimehr B, Mansourian M. Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetes patients. Electron Physician 2017; 9:5960-5968. [PMID: 29560148 PMCID: PMC5843422 DOI: 10.19082/5960] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 09/11/2017] [Indexed: 01/22/2023] Open
Abstract
Background and Objective Diabetes is a chronic disease in which patients require lifelong self-care behaviors. The present study offset to determine the effect of educational intervention based on the Health Belief Model (HBM) on promoting self-care behaviors of type 2 diabetes patients in Ilam, Iran 2014. Methods A quasi-experimental research was conducted based on HBM in which 70 type 2 diabetic patients from Ilam, western Iran in 2014 were selected by multi-stage random sampling. A self-designed questionnaire was used, and pre-test was administered, subsequently, the educational intervention sessions were provided in the form of presentation, questions and answers, group discussion, and practical demonstrations in four sessions over a period of one month. Two months after the intervention, the post-tests were administered. The data were analyzed via SPSS 20 applying independent samples t-test, paired samples t-test, and univariate and multivariate regressions at a significance level of less than 0.05. Results The mean scores of susceptibility, severity, perceived benefits and barriers, self-efficacy, and self-care behaviors were at average and lower levels before the intervention; nonetheless, after the educational intervention, the mean score of each HBM construct and the self-care behaviors significantly increased (p<0.001). Conclusion Health education through HBM promotes the self-care behaviors of patients with type 2 diabetes.
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Affiliation(s)
- Parisa Shabibi
- M.Sc. of Health Education and Promotion, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Sadegh Abedzadeh Zavareh
- Ph.D. of Health Education and Promotion, Assistant Professor, Public Health Department, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Sayehmiri
- Ph.D. of Biostatistics, Associate Professor, Department of Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
| | - Mostafa Qorbani
- Ph.D. of Epidemiology, Assistant Professor, Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Non-communicable Diseases Research Center, Endocrinology and Metabolism Population, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Safari
- Pediatrician, Assistant Professor, Departments of Pediatrics, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Morteza Mansourian
- Ph.D. of Health Education and Promotion, Assistant Professor, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
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Adarmouch L, Elyacoubi A, Dahmash L, El Ansari N, Sebbani M, Amine M. Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2017; 7:54-59. [PMID: 29067251 PMCID: PMC5651287 DOI: 10.1016/j.jcte.2017.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/10/2017] [Accepted: 01/29/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Self-management education (SME) is an important yet unacknowledged aspect of diabetes care. Despite the raise of diabetes and its complications with significant burden in developing countries, research on SME interventions in Morocco is lacking. AIMS To assess the effectiveness of a culturally tailored SME intervention on foot-care self-management practices among type 2 diabetes patients and to identify factors associated with practices variation. METHODS We designed a pre-post prospective quasi-experimental study and recruited patients with type 2 diabetes aged 30 years old or above. The intervention consisted of an interactive group discussion using different materials: a narrative video, a PowerPoint presentation and a printed guide. Foot-care practices were assessed prior to the session and one month later using 2 items from the Summary of Diabetes Self-Care Activities (SDSCA). Binary logistic regression was performed to identify factors associated with a favorable variation, defined as an increase in the mean frequency score of foot-care by a minimum of 1 day/week. RESULTS A total of 199 participants were recruited and 133 completed the second assessment. Mean age was 55.2 ± 11.2 years old. Women represented 67% and 72% of participants was illiterate. The foot-care score mean increased from 3.5 ± 2.9 days to 5.9 ± 1.8 days one month after the intervention (mean variation was 2.4 ± 3.1 days; p < 0.001). A favorable variation was found among 75 (37.7%) participants. In multivariate analysis, literacy was associated with higher likelihood of a favorable variation of foot-care practices (OR = 2.82; 95%CI: 1.09-7.31) while previous education about diabetic foot was associated with lower likelihood of a favorable variation (OR = 0.26; 95%CI: 0.08-0.78). CONCLUSIONS There was a general improvement in foot-care practices after the intervention. Our findings suggest the role of literacy and previous patient education in shaping the observed variation. Culturally tailored interventions targeting other disease management domains are needed in our context.
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Affiliation(s)
- Latifa Adarmouch
- Clinical Research Unit, Mohammed VI University Hospital, Marrakech, Morocco.,Community Medicine and Public Health Department, PCIM Laboratory, School of Medicine, Cadi Ayyad University, Morocco
| | - Abdelhadi Elyacoubi
- Community Medicine and Public Health Department, PCIM Laboratory, School of Medicine, Cadi Ayyad University, Morocco
| | - Latifeh Dahmash
- Community Medicine and Public Health Department, PCIM Laboratory, School of Medicine, Cadi Ayyad University, Morocco
| | - Nawal El Ansari
- Department of Endocrinology and Diabetology, Mohammed VI University Hospital, Marrakech, Morocco
| | - Majda Sebbani
- Clinical Research Unit, Mohammed VI University Hospital, Marrakech, Morocco.,Community Medicine and Public Health Department, PCIM Laboratory, School of Medicine, Cadi Ayyad University, Morocco
| | - Mohamed Amine
- Clinical Research Unit, Mohammed VI University Hospital, Marrakech, Morocco.,Community Medicine and Public Health Department, PCIM Laboratory, School of Medicine, Cadi Ayyad University, Morocco
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Ahmad Sharoni SK, Mohd Razi MN, Abdul Rashid NF, Mahmood YE. Self-efficacy of foot care behaviour of elderly patients with diabetes. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2017; 12:2-8. [PMID: 29423123 PMCID: PMC5791827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour. AIM To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes. METHODS A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 years with specific inclusion criteria were invited to participate in this study. The respondents were interviewed using a set of validated questionnaires. Data were analysed with descriptive and inferential statistics (multiple linear regression) using Statistical Package for the Social Sciences version 20.0. RESULTS Levels of foot self-efficacy (mean+31.39; standard deviation=7.76) and foot care behaviour (mean=25.37; SD=5.88) were high. There was a positive significant relationship between foot self-efficacy (β = 0.41, p < 0.001) and gender (β = 0.30, p < 0.001) with foot care behaviour. CONCLUSION Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.
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Affiliation(s)
- S K Ahmad Sharoni
- (Corresponding author) MscNurs (UM), RN (USM) Universiti teknologi MARA, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia.
| | - M N Mohd Razi
- Bachelor of Nursing (hons) (UiTM) Universiti teknologi MARA, Selangor, Malaysia
| | - N F Abdul Rashid
- Bachelor of Nursing (hons) (UiTM) Universiti teknologi MARA, Selangor, Malaysia
| | - Y E Mahmood
- Bachelor of Nursing (hons) (UiTM) Universiti teknologi MARA, Selangor, Malaysia
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Büyükkaya Besen D, Günüşen N, Arda Sürücü H, Koşar C. Predictor effect of Locus Of Control (LOC) on self-care activities and metabolic control in individuals with type 2 diabetes. PeerJ 2016; 4:e2722. [PMID: 27904812 PMCID: PMC5126624 DOI: 10.7717/peerj.2722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 10/25/2016] [Indexed: 12/28/2022] Open
Abstract
Background Previous studies have examined the role of individuals’ personal characteristics in diabetes management and used the locus of control theory to assess adherence to a diabetes management regimen. These studies have emphasized that having internal locus of control may be a protective factor in diabetes management. Objective The purpose of this study is to determine the predictor effect of locus of control on self-care activities and A1c level. Method The study is descriptive and relational. Researchers used a Diabetes Self-Care Activities Scale and a Locus of Control Scale to collect data. The study sample consisted of 129 individuals with type 2 diabetes. Results The average score of locus of control of individuals with diabetes was 10.26, and the frequency of self-care activities in the past week was 2.9 days. A weak but statistically significant negative relation was found between the locus of control level and self-care activities of individuals with diabetes, which had no effect on A1c. It was determined that locus of control predicts 19% of self-care activities. Conclusion According to the study results, having internal locus of control had positive effects on self-care activities. Training and planning activities to improve internal locus of control can improve diabetes management.
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Affiliation(s)
| | | | | | - Cansu Koşar
- School of Nursing, Celal Bayar University , Manisa , Turkey
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Bell RA, Stafford JM, Arcury TA, Snively BM, Smith SL, Grzywacz JG, Quandt SA. Complementary and Alternative Medicine Use and Diabetes Self-Management Among Rural Older Adults. ACTA ACUST UNITED AC 2016; 11:95-106. [PMID: 19756166 DOI: 10.1177/1533210106292461] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Complementary and alternative medicine (CAM) is a growing form of self-care and is related to other healthy behaviors. This study examines the relationship between CAM use and diabetes self-management. A survey of rural older African American, Native American, and White adults with diabetes was conducted. Data were collected on diabetes self-management domains and general and diabetes-specific CAM use. Some associations were observed, particularly for CAM use and following a healthy eating plan. CAM is part of the health maintenance strategy of rural older adults with diabetes. Further research should examine the health trajectory associated with CAM use in this population.
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Pedras S, Carvalho R, Pereira MDG. Sociodemographic and clinical characteristics of patients with diabetic foot ulcer. Rev Assoc Med Bras (1992) 2016; 62:171-8. [DOI: 10.1590/1806-9282.62.02.171] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/21/2014] [Indexed: 11/21/2022] Open
Abstract
Summary Introduction: Diabetic foot is one of the most serious complications of diabetes affecting about 15% of all diabetes patients, and it is the leading cause of nontraumatic lower limb amputations. This study presents a sociodemographic and clinical characterization of patients with diabetic foot ulcer indicated for amputation surgery. Methods: A cross-sectional study with 206 patients with type 2 diabetes and a diabetic foot ulcer indicated for amputation surgery. Patients were assessed on sociodemographic and clinical characteristics, pain intensity and pain interference, after answering the Brief Pain Inventory, and on pain descriptors according to the Douleur Neuropathique 4. Results: Most patients were male, with little formal education and a mean age of 66 years. They had been diagnosed with type 2 diabetes for 18 years on average, and with diabetic foot ulcer on average 4 years prior to the assessment. About 59% of patients experienced pain in the lower limb that significantly affect all areas of their functioning. Conclusion: The social demographic variables play an important role in diabetic foot ulceration. Given that the neuropathic ulcers are more easily preventable, systematic monitoring of patients with neuropathy is important. In patients with neuroischemic foot, strategies to cope or manage more efficiently the pain are paramount. Intervention should be multidisciplinary and take into account sociodemographic and clinical factors, as well as the presence, intensity and interference of pain in the patient's daily life activities and whether the patient has family or caregiver support.
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31
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Bonner T, Foster M, Spears-Lanoix E. Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabet Foot Ankle 2016; 7:29758. [PMID: 26899439 PMCID: PMC4761684 DOI: 10.3402/dfa.v7.29758] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/27/2015] [Accepted: 11/28/2015] [Indexed: 12/01/2022]
Abstract
Introduction The purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions. Methods Medline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted. Results Thirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices. Conclusion Preventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations.
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Affiliation(s)
- Timethia Bonner
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA;
| | - Margaret Foster
- Health Sciences Center, Texas A&M University, College Station, TX, USA
| | - Erica Spears-Lanoix
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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Foot care practices of diabetic patients in Saudi Arabia. Saudi J Biol Sci 2015; 24:1667-1671. [PMID: 30294233 PMCID: PMC6169502 DOI: 10.1016/j.sjbs.2015.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/15/2015] [Accepted: 12/19/2015] [Indexed: 01/05/2023] Open
Abstract
Diabetic foot is a serious complication that causes lower extremity amputations. The aim of this study was to identify the patient’s awareness about risk factors for diabetic foot disease and to explore the knowledge and foot care practices among diabetic patients in a Saudi population. This cross-sectional study was conducted in King Khalid University Hospital (KKUH), King Abdulaziz University Hospital (KAUH), King Fahad Medical City, National Guard Hospital, Military Hospital, and Prince Salman Hospital capital city of Saudi Arabia. Patients were eligible if they had diabetes foot disease, signed the consent form, and completed the questionnaire. We selected 350 patients from different hospitals between November-2011 and April-2012. The majority of patients (68%) were selected from King Saud University hospitals. The mean age of patients was 50.87 ± 15.9 years with a range of 20–90 years. The majority of patients were male (64.3%) and had a family history of hypertension (55.4%), high total cholesterol (58.6%), and other diabetes (58.9%). A family history of smoking, a major risk factor for diabetic foot, was found in 20.3% of cases. Sixty percent of the patients were using oral medications, 27.1% were using insulin therapy, 10% were using both oral and insulin therapies, and 10% were on diet. In our study, 19.4% of participants were illiterate while 80.6% had a high school or university level education. Our findings also revealed that some patients had a lack of knowledge concerning diabetic foot disease and future complications. Patients are unaware of the risk factors for diabetes foot and practice poor foot care. Awareness programs should be mandatory in all hospitals and diabetes clinics to help compensate for the lack of awareness and lack of podiatric educational services. Such programs may decrease the risk of diabetes foot disease.
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Kueh YC, Morris T, Borkoles E, Shee H. Modelling of diabetes knowledge, attitudes, self-management, and quality of life: a cross-sectional study with an Australian sample. Health Qual Life Outcomes 2015; 13:129. [PMID: 26286395 PMCID: PMC4543474 DOI: 10.1186/s12955-015-0303-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/14/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Quality of life (QoL) is an important aspect of wellbeing for people with chronic conditions like type 2 diabetes, making it a noteworthy outcome. Knowledge about diabetes, attitudes, and self-management of diabetes are key factors that might directly or indirectly impact QoL. However, little is known about the inter-relationships between diabetes knowledge, attitudes, self-management and QoL among people with type 2 diabetes mellitus (T2DM). The aim of this study was to examine a model describing the relationship between diabetes knowledge, attitudes, self-management, and QoL of people with T2DM that is based on previous research linking pairs of these variables. METHODS A cross-sectional study design was employed in this research. A total of 291 participants, 192 males and 99 females, with T2DM, whose mean age was 55.8 (standard deviation = 11.09) completed questionnaires measuring diabetes knowledge (Diabetes Knowledge Scale), attitudes (Diabetes Integration Scale -19), self-management (Summary of Diabetes Self-care Activities Scale), including the aspects of diet, exercise, blood glucose testing, and foot care, and QoL (Diabetes Quality of Life Scale), comprising the aspects of satisfaction and impact on QoL respectively. To examine the model we proposed relating these variables, data were analysed using the path analysis. RESULTS In the final model, diabetes knowledge was a significant predictor for attitudes and self-management in terms of blood glucose testing. Attitudes was a significant predictor for self-management in terms of diet. In addition, self-management in terms of blood glucose testing was a significant predictor of impact of QoL, and self-management in terms of diet was a significant predictor of satisfaction and impact of QoL. Self-management in terms of exercise was a significant predictor of satisfaction in QoL. The final model reflected a good fit (χ(2) (14) = 22.52, p = 0.069; CFI = 0.983; GFI = 0.983; RMSEA = 0.046). CONCLUSIONS Diabetes knowledge, attitudes, and self-management are important factors that can impact the QoL among people with type 2 diabetes.
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Affiliation(s)
- Yee Cheng Kueh
- College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
| | - Tony Morris
- College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
| | - Erika Borkoles
- College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
| | - Himanshu Shee
- College of Business, Victoria University, Melbourne, Australia.
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Quandt SA, Reynolds T, Chapman C, Bell RA, Grzywacz JG, Ip EH, Kirk JK, Arcury TA. Older adults' fears about diabetes: using common sense models of disease to understand fear origins and implications for self-management. J Appl Gerontol 2015; 32:783-803. [PMID: 25364096 DOI: 10.1177/0733464811435506] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examines older adults' fears of diabetes complications and their effects on self-management practices. Existing models of diabetes self-management posit that patients' actions are grounded in disease beliefs and experience, but there is little supporting evidence. In-depth qualitative interviews were conducted with a community-based sample of 74 African American, American Indian, and white older adults with diabetes. Analysis uses Leventhal's Common Sense Model of Diabetes to link fears to early experience and current self-management. Sixty-three identified fears focused on complications that could limit carrying out normal activities: amputation, blindness, low blood glucose and coma, and disease progression to insulin use and dialysis. Most focused self-management on actions to prevent specific complications, rather than on managing the disease as a whole. Early experiences focused attention on the inevitability of complications and the limited ability of patients to prevent them. Addressing older adults' fears about diabetes may improve their diabetes self-management practices.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6015, 336-713-4157 (fax)
| | - Teresa Reynolds
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6722
| | - Christine Chapman
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6015
| | - Ronny A Bell
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard Winston-Salem, NC 27157 336-716-9736
| | - Joseph G Grzywacz
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-2237
| | - Edward H Ip
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 336-716-9833
| | - Julienne K Kirk
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-9043
| | - Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-9438
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Al Sayah F, Soprovich A, Qiu W, Edwards AL, Johnson JA. Diabetic Foot Disease, Self-Care and Clinical Monitoring in Adults with Type 2 Diabetes: The Alberta's Caring for Diabetes (ABCD) Cohort Study. Can J Diabetes 2015; 39 Suppl 3:S120-6. [PMID: 26243464 DOI: 10.1016/j.jcjd.2015.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/20/2015] [Accepted: 05/01/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the prevalence and predictors of foot disease, self-care and clinical monitoring in adults with type 2 diabetes in Alberta, Canada. METHOD Baseline data from a prospective cohort of adults with type 2 diabetes were used. Assessment of foot disease included self-reported peripheral neuropathy, peripheral vasculopathy, foot or leg ulcer/infection or gangrene/amputation. Foot self-care was assessed using the Summary of Diabetes Self-Care Activities, and clinical monitoring using patients' reports of having feet checked for lesions or sensory loss. RESULTS The mean age of respondents (N=2040) was 64 (SD 10.7) years; 45% were female, and 91% were Caucasian. Peripheral neuropathy was reported by 18% of the respondents, peripheral vasculopathy by 28%, ulcer/infection by 6% and gangrene/amputation by 1.4%. Only 14% of respondents performed foot self-care behaviours ≥6 days per week, and only 41% and 34% had their feet clinically checked for lesions or sensory loss, respectively. Predictors of foot disease included longer duration of diabetes, smoking, depressive symptoms, low self-efficacy and a history of cardiovascular diseases. Predictors of good self-care included older age, female sex, longer duration of diabetes and no report of hyperlipidemia. Predictors of clinical monitoring included female sex, current smoking, residing in urban areas, longer duration of diabetes, and histories of heart disease or hyperlipidemia. CONCLUSIONS Peripheral neuropathy and vasculopathy were the most common reported foot problems in this population. Foot self-care is generally infrequent, and clinical monitoring is performed for less than half of these patients, with significant variations by patient demographics and clinical presentation.
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Affiliation(s)
- Fatima Al Sayah
- Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Soprovich
- Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Weiyu Qiu
- Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Alun L Edwards
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- Alliance for Canadian Health Outcomes Research in Diabetes, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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Chourdakis M, Kontogiannis V, Malachas K, Pliakas T, Kritis A. Self-care behaviors of adults with type 2 diabetes mellitus in Greece. J Community Health 2015; 39:972-9. [PMID: 24519180 DOI: 10.1007/s10900-014-9841-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine self-care behaviors of adults with type 2 diabetes mellitus living in the Metropolitan Area of Thessaloniki in Northern Greece. The Summary of Diabetes Self-Care behaviors measurement was administered to 215 patients, out of which 177 were eligible to participate (87 males). Patients, aged 30 years or more, were recruited through a university hospital day-clinic. Older patients (>65 years), as well as those with "higher educational level" did not distribute their daily carbohydrate intake equally. Nevertheless, they were more likely to adapt to their physician's recommendations regarding medication and to regularly perform suggested blood glucose checking. Exercise patterns were more often found for higher educated, earlier diagnosed males. Younger patients were less likely to follow their healthcare professional's recommendations, regarding diet, medication intake, blood glucose checking, foot care and exercise compared to older patients. These results pose a higher risk for complications and morbidity in younger patients with type 2 diabetes mellitus, who most possibly will require intensive treatment in the future.
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Affiliation(s)
- Michael Chourdakis
- Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54006, Thessaloniki, Greece,
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Do V, Young L, Barnason S, Tran H. Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals. F1000Res 2015. [PMID: 26213616 PMCID: PMC4505779 DOI: 10.12688/f1000research.6557.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate heart failure knowledge (p=.005), low self-efficacy (p<.001) and low engagement in heart failure self-management behaviors (p<.001) after discharge from hospital.
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Affiliation(s)
- Van Do
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Lufei Young
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Sue Barnason
- College of Nursing-Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Hoang Tran
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA
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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. [PMID: 26064190 PMCID: PMC4462176 DOI: 10.1186/s13047-015-0080-y] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 06/01/2015] [Indexed: 01/05/2023] Open
Abstract
Background At the time of diagnosis, more than 10 % of people with type 2 diabetes mellitus have one or two risk factors for a foot ulceration and a lifetime risk of 15 %. Diabetic foot ulcers can be prevented through well-coordinated foot care services. The objective of this study was to determine knowledge of foot care and reported practice of foot self-care among diabetic patients with the aim of identifying and addressing barriers to preventing amputations among diabetic patients. Methods Patients were randomly selected from all public diabetic clinics in Dar es Salaam. A questionnaire containing knowledge and foot care practice questions was administered to all study participants. A detailed foot examination was performed on all patients, with the results categorized according to the International Diabetes Federation foot risk categories. Statistics were performed using SPSS version 14. Results Of 404 patients included in this study, 15 % had foot ulcers, 44 % had peripheral neuropathy, and 15 % had peripheral vascular disease. In multivariate analysis, peripheral neuropathy and insulin treatment were significantly associated with presence of foot ulcer. The mean knowledge score was 11.2 ± 6.4 out of a total possible score of 23. Low mean scores were associated with lack of formal education (8.3 ± 6.1), diabetes duration of < 5 years (10.2 ± 6.7) and not receiving advice on foot care (8.0 ± 6.1). Among the 404 patients, 48 % had received advice on foot care, and 27.5 % had their feet examined by a doctor at least once since their initial diagnosis. Foot self-care was significantly higher in patients who had received advice on foot care and in those whose feet had been examined by a doctor at least once. Conclusions The prevalence of diabetic foot is high among patients attending public clinics in Dar es Salaam. There is an urgent need to establish coordinated foot care services within the diabetic clinic to identify feet at risk, institute early management, and provide continuous foot care education to patients and health care providers.
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Affiliation(s)
- Faraja S Chiwanga
- Muhimbili National Hospital, Kalenga Street, Upanga, P.O Box 65000, Dar es Salaam, Tanzania
| | - Marina A Njelekela
- Muhimbili National Hospital, Kalenga Street, Upanga, P.O Box 65000, Dar es Salaam, Tanzania ; Muhimbili University of Health and Allied Sciences, Mindu Street, Upanga, P.O Box 65001, Dar es Salaam, Tanzania
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Matricciani L, Jones S. Who cares about foot care? Barriers and enablers of foot self-care practices among non-institutionalized older adults diagnosed with diabetes: an integrative review. DIABETES EDUCATOR 2014; 41:106-17. [PMID: 25480398 DOI: 10.1177/0145721714560441] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE Appropriate and timely foot self-care practices may prevent diabetes-related foot complications. However, self-care practices are often neglected, particularly by older adults. The purpose of this study was to conduct an integrative, systematic literature review of the psychosocial barriers and enablers of foot self-care practices among older adults diagnosed with diabetes. METHODS An integrative, systematic literature review and a deductive thematic analysis was conducted to determine psychosocial barriers and enablers of foot self-care practices among older adults. RESULTS A total of 130 different studies were retrieved from the search strategy. From these, 9 studies were identified and included for review. Physical ability, perceived importance, patient knowledge, provision of education, social integration, risk status, and patient-provider communication were identified as key barriers and enablers of foot self-care. Participants at high risk of foot complications were found to perceive themselves at greater risk of complications, receive more education, and engage in better overall foot self-care practices compared to those at low risk of foot complications. CONCLUSION Foot self-care practices appear underutilized as primary prevention measures by older adults and are instead adopted only once complications have already occurred. Likewise, facilitators of foot self-care practices, such as education, appear to be reserved for individuals who have already developed foot complications. Health care professionals such as diabetes educators, podiatrists, and general practitioners may play an important role in the prevention of foot complications among older adults by recognizing, referring, and providing early education to older adults.
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Affiliation(s)
- Lisa Matricciani
- Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide, Australia (Ms Matricciani, Dr Jones)
| | - Sara Jones
- Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide, Australia (Ms Matricciani, Dr Jones)
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Dikeukwu RA, Omole OB. Awareness and practices of foot self-care in patients with diabetes at Dr Yusuf Dadoo district hospital, Johannesburg. JOURNAL OF ENDOCRINOLOGY METABOLISM AND DIABETES OF SOUTH AFRICA 2014. [DOI: 10.1080/22201009.2013.10872314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- RA Dikeukwu
- Department of Family Medicine, University of the Witwatersrand, Johannesburg
| | - OB Omole
- Clinical Unit (Family Medicine), Sedibeng District Department of Family Medicine, University of the Witwatersrand, Johannesburg
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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. [DOI: 10.12968/jowc.2014.23.5.247] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M. Z. Abu-Qamar
- School of Nursing and Midwifery, Faculty of Health Sciences, Curtin University, Perth, Western Australia
- Department of Adult Health Nursing, Faculty of Nursing, Mu'tah University, Mu'tah, Jordan
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Madarshahian F, Hassanabadi M, Koshniat Nikoo M. Cognitive status and foot self care practice in overweight diabetics, engaged in different levels of physical activity. J Diabetes Metab Disord 2014; 13:31. [PMID: 24495364 PMCID: PMC3922616 DOI: 10.1186/2251-6581-13-31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 01/19/2014] [Indexed: 01/15/2023]
Abstract
Background Type 2 diabetes along with chronic hyperglycemia may result in cognitive impairment. This can negatively affect the patient’s adherence to diabetes treatment. The purpose of this study was to compare the cognitive status and foot self care practice in overweight type 2 diabetic patients who exercised regularly and those who did not. Methods The comparative study was conducted on 160 consecutive patients from an outpatient diabetes clinic. They were divided into two groups: The active group comprised of 80 patients engaged in regular exercise for at least 15–30 minutes, three times per week during the past 6 months. The control group included 80 patients who had not exercised regularly for the past 12 months, matched for sex, age, education, diabetes duration, hemoglobin A1C and body mass index (BMI: 25–29.9Kg/m2). Data on the patients’ demographic information, foot care practice and physical activity habits were gathered using a questionnaire. The Mini Mental Status examination (MMSE) was applied to assess cognitive status. Results MMSE score was significantly higher in the active group. A significant negative correlation was noted between MMSE scores and BMI in the control group (r = −0.2, P = 0.03). A significant difference was noted in the four domains of foot self care practice between the active (4.77 ± 0.77) and control (4.45 ± 0.83) groups (P < 0.01). Conclusions Regular physical activity can help promote cognitive status and foot self care practice in overweight patients with type 2 diabetes.
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Affiliation(s)
| | - Mohsen Hassanabadi
- Community and Public Health Department, Birjand University of Medical Sciences, Ghafary Avenue, Birjand 9717853577, Iran.
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Nguyen HT, Kirk JK, Arcury TA, Ip EH, Grzywacz JG, Saldana SJ, Bell RA, Quandt SA. Cognitive function is a risk for health literacy in older adults with diabetes. Diabetes Res Clin Pract 2013; 101:141-7. [PMID: 23806477 PMCID: PMC3742688 DOI: 10.1016/j.diabres.2013.05.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/20/2013] [Accepted: 05/30/2013] [Indexed: 01/21/2023]
Abstract
AIMS Cognitive impairment is common in older adults with diabetes, yet it is unclear to what extent cognitive function is associated with health literacy. We hypothesized that cognitive function, independent of education, is associated with health literacy. METHODS The sample included 537 African American, American Indian, and White men and women 60 years or older. Measures of cognitive function included the Mini-Mental State Examination (MMSE), Verbal Fluency, Brief Attention, and Digit Span Backward tests. Health literacy was assessed using the S-TOFHLA. RESULTS Cognitive function was associated with health literacy, independent of education and other important confounders. Every unit increase in the MMSE, Digit Span Backward, Verbal Fluency or Brief Attention was associated with a 20% (p<.001), 34% (p<.001), 5% (p<.01), and 16% (p<.01) increase in the odds of having adequate health literacy, respectively. CONCLUSIONS These results suggest that cognitive function is associated with health literacy in older adults with diabetes. Because poor cognitive function may undermine health literacy, efforts to target older adults on improving health literacy should consider cognitive function as a risk factor.
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Affiliation(s)
- Ha T Nguyen
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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Mohebi S, Azadbakht L, Feizi A, Sharifirad G, Kargar M. Review the key role of self-efficacy in diabetes care. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2013; 2:36. [PMID: 24083286 PMCID: PMC3778564 DOI: 10.4103/2277-9531.115827] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION AND AIMS Diabetes is one of the chronic and prevalent diseases in the world. Diabetic patients' number has increased 7 times during last 20 years. If this current situation continues, diabetic patients' population will be 350 millions ones in 2030. It means that 7 millions people will be added annually. Up to now, different uncontrollable factors have been monitored in self-caring of this disease for managing and preventing from its early and late side effects. This research is conducted to study the role of self-efficacy as a determinant agent in self-caring of diabetic patients. STUDY METHOD This is a narrative review study in which various information banks and search motors such as PubMed, ProQuest, SCOPUS, Elsevier were reviewed. Diabetes, self-care and self efficacy keywords from cross sectional, cohort, clinical experimental studies and systematic review were also used in the study construction. Iranian Banks such as IRANMEDEX, MEDLINE and also different articles from domestic research and scientific magazines were selected. Time spectrum of reviewed studies was supposed to be published from 1990 up to 2011. RESULTS Self-care situation among diabetic patients not only is unsatisfactory but also the studies' results show that self-efficacy rate is low among them. The findings of the studies prove that there is a direct relation between self-efficacy and self-care in the patients in a way that this construct owns the predictability power of self-care behavior. CONCLUSION Self-caring has a significant role in controlling of diabetes disease. Self-efficacy can induce motivation directly take health promoting behavior through efficacy expectations. It also affects motivation, indirectly, through perceived barriers and determining commitment or stability for following function map. So, self-efficacy is very important in changing self-care behavior process.
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Affiliation(s)
- Siamak Mohebi
- Department of Public health, Qom University of Medical Sciences, Qom, Iran
| | - Leila Azadbakht
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Avat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Sharifirad
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Kargar
- Department of Public Health, School of Public Health, Fars University of Medical Sciences, Fars, Iran
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Mohebi S, Azadbakht L, Feizi A, Sharifirad G, Kargar M. Structural role of perceived benefits and barriers to self-care in patients with diabetes. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2013; 2:37. [PMID: 24083287 PMCID: PMC3778565 DOI: 10.4103/2277-9531.115831] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION AND GOAL In diseases and disorders such as diabetes, treatment and disease management depends mostly on patient's performance. So, self-care is very important in these patients and they can affect their own welfare, functional capabilities, and disease processes by achieving self-care skills. Nowadays, we know that self care follows individual, psychological and social factors which its recognition can assist health care providing systems to carry out educational programs. This study aimed to investigate the role of perceived benefits and barriers in doing self-care behaviors among diabetic patients. MATERIALS AND METHODS This study is a narrative review and articles with sectional, cohort, and interventional, clinical trial, qualitative and narrative designs were chosen using databases and academic search engines such as PubMed, SCOPUS, ProQuest, Elsevier and key words like self-care diabetes, perceived benefits and barriers. Persian articles were also selected using databases like IRANMEDEX, MEDLIB, as well as searching the articles in sites of domestic scientific magazines. RESULTS Reviewed articles' findings show the average situation of perceived benefits and barriers in diabetic patients regarding self-care. Qualified blood sugar (glucose) control, weight control, happiness feeling and expenses reduction are the most important perceived benefits. The most significant perceived barriers in self-care consist of lack of family support, shame feeling, forgetfulness and not being able to ignore foods' flavor. CONCLUSION Perceived benefits and barriers, as central constructs in some patterns and theories of behavior change, were related to self-care, so that it was directly related to perceived benefits and reversely related to perceived barriers. Therefore, these two constructs can be considered as strategies for promoting self-care behaviors in diabetic patients.
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Affiliation(s)
- Siamak Mohebi
- Department of Public health, Qom University of Medical Sciences, Qom, Iran
| | - Leila Azadbakht
- Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Avat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Sharifirad
- Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Kargar
- Department of Public Health, School of Public Health, Fars University of Medical Sciences, Fars, Iran
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Chin YF, Huang TT, Hsu BRS. Impact of action cues, self-efficacy and perceived barriers on daily foot exam practice in type 2 diabetes mellitus patients with peripheral neuropathy. J Clin Nurs 2012; 22:61-8. [PMID: 23121425 DOI: 10.1111/j.1365-2702.2012.04291.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2012] [Indexed: 01/09/2023]
Abstract
AIMS AND OBJECTIVES To identify the effects of health belief model factors on daily foot-exam practice among diabetes mellitus patients with peripheral neuropathy. BACKGROUND Daily foot exams are one of the most important self-care behaviours that prevent the occurrence of diabetic foot ulcers and subsequent amputation. Although daily foot exams were under-practiced in patients with peripheral neuropathy, few studies have explored modifiable social-psychological factors related to daily foot exams. DESIGN A cross-sectional survey was used to collect the data. METHODS A total of 277 patients with diabetes and peripheral neuropathy were recruited from two hospitals in northern Taiwan. The Family APGAR and Diabetic Foot Ulcer Health Belief Scale (DFUHBS) were used to measure family support and health belief factors respectively. Data on foot-exam practice, perceived self-efficacy and action cues were collected through the use of structured questionnaires. The data were analysed using logistic regression. RESULT The regression model revealed that select action cues (recommendations from family, friends, or health professionals), perceived self-efficacy and perceived barriers interactively influenced the participants' daily foot-exam practice. CONCLUSION Factors related to daily foot-exam practice were identified. Specifically, action cues played a significant role in motivating daily foot-exam practice in this group. RELEVANCE TO CLINICAL PRACTICE This study recognises modifiable factors that influence the daily foot-exam practice of patients with diabetes and peripheral neuropathy. Using the findings of this study, health professionals can design interventions that aim to modify the above factors as a means to promote daily foot-exam practice.
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Affiliation(s)
- Yen-Fan Chin
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan and School of Nursing, Chang Gung University, Tao-Yuan, Taiwan
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Personal and Cultural Influences on Diabetes Self-Care Behaviors Among Older Hispanics Born in the U.S. and Mexico. J Immigr Minor Health 2012; 14:1052-62. [DOI: 10.1007/s10903-012-9639-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nguyen HT, Grzywacz JG, Quandt SA, Neiberg RH, Lang W, Altizer K, Stoller EP, Bell RA, Arcury TA. The relationship between cognitive function and non-prescribed therapy use in older adults. Aging Ment Health 2012; 16:648-58. [PMID: 22304694 PMCID: PMC3346852 DOI: 10.1080/13607863.2011.644265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To examine the association of cognitive function with use of non-prescribed therapies for managing acute and chronic conditions, and to determine whether use of non-prescribed therapies changes over time in relation to baseline cognitive function. METHODS 200 community-dwelling adults aged 65 and older were recruited from three counties in south central North Carolina. Repeated measures of daily symptoms and treatment were collected on three consecutive days at intervals of at least one month. The Mini-Mental State Examination, the primary cognitive measure, was collected as part of the baseline survey. Data were collected on the daily use of common non-prescribed therapies (use of prayer, ignore symptoms, over-the-counter remedies, food and beverage therapies, home remedies, and vitamin, herb, or supplements) on each of the three days of the follow-up interviews for up to six consecutive months. RESULTS Older adults with poorer cognitive function were more likely to pray and ignore symptoms on days that they experienced acute symptoms. Poorer cognitive function was associated with increased use of home remedies for treating symptoms related to existing chronic conditions. CONCLUSIONS Cognitive function may play a role in why older patients use some non-prescribed therapies in response to acute and chronic conditions.
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Affiliation(s)
- Ha T Nguyen
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, USA.
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Johnson AE, Lavernia C. Breakout session: Ethnic and gender differences in diabetic foot management and amputations. Clin Orthop Relat Res 2011; 469:1967-70. [PMID: 21184206 PMCID: PMC3111763 DOI: 10.1007/s11999-010-1742-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although the health status of all Americans has improved substantially in the past century, gender and ethnic disparities still persist. Gender and ethnic disparities in diabetic foot management and amputations are an important but largely ignored issue in musculoskeletal health care. QUESTIONS/PURPOSES Our purposes were to (1) clarify where we are now, (2) describe ways to get where we need to go, and (3) suggest solutions for how we get there, with respect to gender and ethnic disparities in diabetic foot management and amputations. WHERE ARE WE NOW?: Studies investigating socioeconomic, cultural, racial, and biologic contributing factors on gender and ethnic musculoskeletal healthcare disparities have found no single root cause. Studies into disparities in diabetic foot management and amputation have discordant methodologies and most are retrospective. Effective intervention strategies to eliminate these disparities are nonexistent. WHERE DO WE NEED TO GO?: The orthopaedic leadership should lead the movement to create a clearly defined strategy and assist young investigators to gain access to large datasets to study this problem. Orthopaedic specialty society leaders should help to create valid outcome tools, especially on peripheral vascular disease and amputations. HOW DO WE GET THERE?: The working group proposed a three-pronged strategy of education, research, and advocacy to help address this problem.
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Affiliation(s)
- Anthony E. Johnson
- Department of Orthopaedics & Rehabilitation (MCHE-DOR-O), San Antonio Military Medical Center, 3851 Roger Brooke Drive, Building 3600, Fort Sam Houston, TX 78234 USA
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Ko IS, Lee TH, Kim GS, Kang SW, Kim MJ. Effects of visiting nurses' individually tailored education for low-income adult diabetic patients in Korea. Public Health Nurs 2011; 28:429-37. [PMID: 22092426 DOI: 10.1111/j.1525-1446.2011.00941.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the effects of individually tailored education by visiting nurses for low-income adult diabetic patients. DESIGN AND SAMPLE This one-group pretest-posttest study included 96 newly registered low-income adult diabetic patients in a public health center in DJ-gu (similar to a county in the United States) in 2006; the patients met the selection criteria. MEASURES Diabetes knowledge, self-management, and blood glucose levels were compared before and after education. INTERVENTION 15 visiting nurses delivered individually tailored education for 60-90 min/month for 7 months. RESULTS After education, diabetes knowledge (p<.001) and self-management in all categories of lifestyle (p<.001), diet (p<.001), exercise (p<.001), foot care (p<.001), medication (p=.004), and insulin therapy (p=.022) significantly improved. The mean fasting blood glucose (FBG) level decreased by 14.53 mg/dl; this decrease was insignificant (p=.117). However, the relationship between education and FBG levels was significant (χ(2)=40.11, p=.005). CONCLUSIONS Tailored education effectively improved the patients' knowledge of diabetes and self-management. Therefore, regular, individually tailored education on a long-term basis by visiting nurses can provide essential education to low-income adult diabetic patients for maintaining self-management.
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Affiliation(s)
- Il Sun Ko
- College of Nursing, Nursing Policy Research Institute, Yonsei University, Seoul, Korea
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