A Survey of Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer in Bangladesh

Abstract

Diabetic foot ulcer is a preventable complication of diabetes. Nurses must have knowledge related to this condition so that education can be given to patients. This study aims to examine the level of nurses' knowledge regarding prevention and management of diabetic foot ulcer in Bangladesh. A survey involved 218 nurses working at a national, specialized, and well-established institute of diabetic care of Bangladesh. The Nurses' Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer Questionnaire (NKPM-DFUQ) comprising of 40 questions with 20 true/false questions and 20 multiple choice questions was used. It was content validated and tested for internal consistency and stability yielding acceptable levels of reliability. The findings revealed that nurses had very low level of knowledge (M=52.60%, SD=7.86%). The content areas most nurses did not have knowledge were detecting loss of protective sensation of the feet, caring of callus formation, encouraging patients to have activity of daily living in order to self-manage, setting a goal for prevention of amputation, and giving advice to patients that causes of diabetes is the least important element in diabetic foot care program. The findings are beneficial for establishing training courses. Consequently, quality of care for patients with diabetes will be improved.

Nurses' knowledge on diabetic foot ulcer disease and their attitudes towards patients affected: A cross‐sectional institution‐based study

“…Most studies on pressure ulcer prevention and care have reported comparable results (Nuru et al., ; Uba et al., ). Very low knowledge on diabetic ulcer disease reported in a survey conducted in Bangladeshi nurses can be attributed to their lack of training and knowledge update (Sharmisthas et al., ). Also, surprisingly low knowledge scores were reported in Jordanian nurses, although all of them were degree holders (Qaddumi & Khawaldeh, ).…”

“…MCQs had three answer options, “true,” “false” and “do not know.” The third option was included to minimise guessing and to prevent leaving questions unanswered (Qaddumi & Khawaldeh, ). When scoring, correct answers scored 1 point each, while incorrect answers and “do not know” options scored zero (Sharmisthas et al., ). The total number of correct answers was computed to a percentage score and categorised according to McDonald's standard learning outcome measured criteria (McDonald, ) to evaluate the knowledge level of nurses (Uba et al., ).…”

“…Broad areas in which knowledge deficits were identified include, positioning and staging of patients (Chianca, Rezende, Borges, Nogueira, & Caliri, ), ulcer assessment (Oseni & Adejumo, ), documentation (Ylönen, Stolt, Leino‐kilpi, & Suhonen, ) and knowledge on new wound dressing material (Couilliet, Michel, Fuchs, Haller, & Guillaume, ). Studies carried out on nurses from different settings seem to show variations in wound care knowledge (Haram, Ribu, & Rustøen, ; Oseni & Adejumo, ; Sharmisthas, Wongchan, & Hathairat, ) which can be attributed to the experience they receive. Nurses in community healthcare services believe that their knowledge on treatment of leg and foot ulcers is insufficient (Haram et al., ) probably due to the limited nursing practice they are exposed to and dependence on colleagues for knowledge.…”

“…Unsatisfactory knowledge found in this study was attributed to the inadequacies of their nursing education and training. Most nurses in this sample were diploma holders with no specialised knowledge on diabetic ulcer care (Sharmisthas et al., ). Although improvement of knowledge is expected with increasing nursing experience, surprisingly insufficient knowledge on pressure ulcer prevention (Gunningberg et al., ) was reported in a study where the majority were experienced nurses.…”

“…Studies carried out on nurses from different settings seem to show variations in wound care knowledge (Haram, Ribu, & Rustøen, 2003;Oseni & Adejumo, 2014;Sharmisthas, Wongchan, & Hathairat, 2014) which can be attributed to the experience they receive. Nurses in community healthcare services believe that their knowledge on treatment of leg and foot ulcers is insufficient (Haram et al, 2003) probably due to the limited nursing practice they are exposed to and dependence on colleagues for knowledge.…”