Promoting foot self‐care in type 2 diabetes mellitus patients receiving hemodialysis based on the information‐motivation‐behavioral skills model

Abstract

This study develops and verifies the use of the foot self‐care behavioral model in patients with type 2 diabetes mellitus (T2DM) receiving hemodialysis (HD) based on the information‐motivation‐behavioral skills model. Data were collected between June and August 2021 from 156 outpatients with type 2 diabetes who were receiving regular HD. A structured questionnaire and electronic medical records were used to collect demographic and disease‐related data along with Foot Care Knowledge Questionnaires, third version of Diabetes Attitude Scale, Multidimensional Scale of Perceived Social Support, Foot Care Confidence Scale, and Foot Self‐care Behavior Scale. Age, diabetic foot care knowledge, social support, and foot care self‐efficacy had a direct effect on foot self‐care behavior. Foot care self‐efficacy had a mediating effect on foot care knowledge, diabetes‐related attitudes, social support, and foot self‐care behavior. The information‐motivation‐behavioral skills model was suitable as a foot self‐care behavioral model for patients with T2DM receiving HD. Additionally, these findings suggest that it is crucial to improve foot self‐care behavior through increased foot care knowledge, diabetes‐related attitudes, and social support, which could contribute to enhancing foot care self‐efficacy.