Evaluation of Knowledge Levels About Diabetes Foot Care and Self-Care Activities in Diabetic Individuals

Implications on self-care behaviors among older Korean immigrants diagnosed with diabetes residing in the United States: a path analytical approach

Background

Diabetes is a prevalent chronic disease. Although self-care is the crucial element in managing diabetes, older Korean immigrants with diabetes face challenges in performing effective self-care related to vulnerability as minority immigrants.

Purpose

This study measures sociodemographics, self-efficacy, social support, diabetes knowledge, and diabetes self-care activities among older Korean immigrants in the United States. This study also aims to demonstrate the direct and indirect effects of the related factors on diabetes self-care activities using a path analysis.

Methods

This study uses a cross-sectional design. Convenience sampling targeted Korean immigrants aged 55 or older using paper and online surveys. Four instruments were used to measure variables: self-efficacy was measured by the General Self-Efficacy scale, diabetes knowledge by the Simplified Diabetes Knowledge Test, social support by the Lubben Social Network Scale-6, and diabetes self-care by the Summary of Diabetes Self-Care Activities questionnaire. Using path analysis, the effects of related factors on self-care activities were analyzed.

Results

190 older Korean immigrants participated, 53.2% female, and 46.8% male. The mean age was 67.2 (SD = 9.9; range, 58-93). A path model shows that sociodemographics (sex, age, education, and years in the United States), diabetes knowledge, self-efficacy, and family support predict diabetes self-care.

Conclusions

The path model demonstrates the effects of sociodemographics, self-efficacy, diabetes knowledge, and social support on diabetes self-care among older Korean immigrants. The findings can help to understand diabetes self-care among the minority ethnic older group and can be used to develop culturally tailored education, counseling, and healthcare services.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01363-6.

Knowledge and Behaviors of Foot Care in Muslims With Diabetes Mellitus: Does Islamic Ritual Ablution Make a Difference?

INTRODUCTION

This study aimed to determine the relationship between ablution ritual and foot knowledge, self-care behaviors, and the presence of diabetic foot ulcers in Muslims with type 2 diabetes mellitus (T2DM).

METHODOLOGY

A descriptive, comparative method was utilized to identify ablution ritual and foot knowledge, self-care behaviors, and the presence of diabetic foot ulcers.

RESULTS

There were 228 persons with T2DM, with 162 participants (71.1%) in the ablution group and 66 participants (28.9%) in the no-ablution group, with 19.7% having diabetic foot ulcers. Diabetic foot knowledge and foot self-care behaviors of persons with T2DM were below a medium level, and there was a significant difference between ablution behavior and the presence of diabetic foot ulcers (x2 =6.646, p<.05).

DISCUSSION

Culturally congruent interventions that acknowledge and understand the cultural practices and beliefs of Muslims with T2DM may be recommended to enhance their knowledge levels and promote positive behavior changes.

The Effect of Foot Care Education for Patients with Diabetes on Knowledge, Self-Efficacy and Behavior: Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to synthesize randomized controlled trials on the impact of foot care education on knowledge, self-efficacy and behavior in patients with diabetes. A search was made using PubMed, Web of Science, Science Direct, Google Scholar, YOK National Thesis Center and Google Scholar electronic databases for studies published between March 2003-January 2022. The search medical subject headings (MeSH) terms were diabetic foot, knowledge, self-efficacy, and behavior. Studies suitable for the systematic review and the meta-analysis met the following criteria (PICOS): target participants would be diagnosed with diabetes (population), diabetic foot education (intervention), comparison of the group receiving diabetic foot care education and routine care education, and the control group receiving only routine care education (comparison), studies evaluating the levels of knowledge, self-efficacy and behavior (outcome), randomized controlled trials (study design). Twenty-six studies were included in systematic review. Three studies for knowledge, 5 studies for behavior, 8 studies for self-efficacy were included in the meta-analysis (total sample: 2534, experiment: 1464, control: 1071). All of the studies had low reporting bias. The mean duration of educations for knowledge was 5.2 months. This duration was 4.8 months for behavior and 4.5 months for self-efficacy. In the random effect (since the homogeneity test: P < .001, this model was used), there were significantly difference in terms of knowledge (standardized mean difference (SMD): 1.656, 95% [CI]: 1.014-2.299, P < .001), and behavior (SMD: 1.045, 95% CI: 0.849-1.242, P < .001). But no difference was observed in terms of self-efficacy (SMD: 0.557, 95%CI: -0.402-1.517, P > .05). The results of a systematic review of twenty-six studies and a meta-analysis of 9 studies showed that diabetic foot education improved the level of knowledge and behavior of patients with diabetes, while not affecting their self-efficacy. Educational interventions with long-term follow-up are needed to address the growing health care needs of patients with diabetes.

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

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.

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

Background:

Diabetes mellitus patients are more likely to undergo nontraumatic foot or leg amputations because they have decreased circulation to the feet or reduced sensation. This condition may cause ulcerations, infections, and delayed wound healing, leading to amputations. Adequate knowledge and practices regarding foot care will be vital in the prevention of diabetic foot complications. Hence, this study aimed to determine the level of knowledge and practices of foot care among diabetes mellitus patients attending a rural primary health center in Belagavi-South India.

Materials and Methods:

A cross-sectional study was conducted in the rural field practice area of J.N. Medical College, Belagavi, for 7 months (November 2019 to May 2020). A pretested questionnaire was administered to 461 diabetes patients attending the health center. A written informed consent was obtained from each participant. They were interviewed with a questionnaire consisting of 15 “yes” or “no” questions, each on foot care knowledge and practice.

Results:

The mean age of the study participants was 50.28 ± 9.48 years. The mean duration of diabetes was 10.69 ± 7.09 years. Majority, i.e., 296 (64.2%) participants showed satisfactory knowledge and 293 (63.6%) showed satisfactory practice. Only 97 (21%) had poor knowledge, 90 (19.5%) had poor practice, 68 (14.8%) patients had good knowledge, and 78 (16.9%) had good practice about diabetic foot care.

Conclusions:

The low level of knowledge and practice in patients with diabetes regarding foot care necessitates an educational program to increase awareness related to foot complications of diabetes, thereby motivating diabetic patients to incorporate foot care practices in their day-to-day routine.