Foot care knowledge, attitudes and practices among patients with diabetic foot and amputation in St. Kitts and Nevis

Abstract

About one‐third of admissions to the surgical unit annually are diabetes foot infections in need of amputation In St. Kitts and Nevis. However, the risk factors related to diabetes foot and amputation remain unknown. This study investigated factors associated with diabetic foot and amputation (DFA). Retrospective case control study design, and purposive and quota sampling method was used to recruit the participants. Patients with and without DFA were interviewed at two main hospitals, several primary health centres, and a private doctor's office during July and August 2018. Self‐development questionnaires were applied to assess patients' demographic, physical and behaviour, foot care knowledge, attitudes, and practices related to DFA. Chi‐square, t‐test, and multiple logistic regressions were used to analyse the data. A total of 210 patients were evaluated, 89 had DFA, while 121 did not, with a mean age of 61.10 (SD = 11.85). Participants' responses indicated good knowledge, favourable attitudes, and adequate practices related to foot care. The two items of the questionnaire, ways to maintain blood flow in the lower extremities and wash their feet daily, had significant lower score in DFA group. In multiple logistic regression, knowledge, attitudes, and practices related to foot care were not a significant predictor of DFA. Being male was a predictor of DFA than female (OR = 3.53; 95% CI = 1.65‐7.57; P < .01). Participants who were currently unemployed were less likely to have DFA than those who were employed (OR = 0.38; 95% Cl = 0.17‐0.86; P < .05). Comparing patients with the longest experience of diabetes mellitus (31 years or more) with those who had diabetes for the shortest period of time (between 1 and 10 years) was less likely to have DFA (OR = 0.38; 95% CI = 0.15‐0.97; P = <.05). The combination of these independent variables could explain 29% of the variance in DFA. Based on these findings, strategies to prevent diabetic foot and amputation should focus on male and outdoor heavy worker, and longer duration of diabetes patients which are identified in this study.

Self-Care in Type 2 Diabetes Patients with Urgency Lower Limb Amputation: The Influence of Sex, Marital Status and Previous Amputations

“…It is known that foot care involves more than performing care tasks, highlighting the knowledge, attitudes and practices of patients with diabetic and amputated feet. 20,21 Family, economic, and working conditions, along with health system-related factors are the most important elements in the care of patients with diabetes and amputations. 20 In fact, support from family members and friends can be an important source of self-management support, 21 and can putatively explain our findings regarding the difference in the more positive diet when considering marital status comparing patients who live with or without a partner, since forty-four percent of US adults help a family member or friend with chronic disease management and another 9% are willing to start.…”

“…20,21 Family, economic, and working conditions, along with health system-related factors are the most important elements in the care of patients with diabetes and amputations. 20 In fact, support from family members and friends can be an important source of self-management support, 21 and can putatively explain our findings regarding the difference in the more positive diet when considering marital status comparing patients who live with or without a partner, since forty-four percent of US adults help a family member or friend with chronic disease management and another 9% are willing to start. 21,22 The logistic regression analysis showed that Marital Status presented significance (p=0.028) in item 2: Specific Food, for sub-item 2.2: Eating high-fat food meat and/or whole milk products and a tendency (p=0.058) for sub-item 2.3: Eating sweets.…”

“…It is known that foot care involves more than performing care tasks, highlighting the knowledge, attitudes and practices of patients with diabetic and amputated feet. 20 , 21 …”

Research of Knowledge and Attitudes of Patients with Diabetic Foot Ulcer Regarding Foot Care

“…Diabetes mellitus is becoming more common with each passing year, with the number of people living with diabetes expected to rise 1.5 fold from 463 million in 2019 to 700 million in 2045. Diabetic foot ulcers, one of the most serious complications of diabetes, macrovascular disease and microvascular damage accompanied by neuropathy and ischemic problems, which facilitates the development of infection, ulcer and gangrene and eventually causes morbidity and mortality, is a difficult, long and costly health problem [1,2]. The global prevalence of diabetic foot ulcers has been reported to be 6.3% [3].…”

“…The global prevalence of diabetic foot ulcers has been reported to be 6.3% [3]. Individuals' quality of life suffers as a result of complications caused by diabetic foot ulcers, as well as a rise in mortality and a physical, psychological, and economic burden [2,4,5].…”