Assessment of Preventive Foot Care Practices among Patients with Diabetes Mellitus Type II

Abstract

Background: Diabetic foot problems are one of the most important complications of diabetes mellitus which causing a worldwide high cost morbidity which could be due to poor self-practices. Objectives: To assess the preventive food care practices among diabetic patients and to find out any significant association of these practices with selected socio-demographical and diabetic related characteristics. Patients and Methods: A descriptive cross-sectional study was conducted in Baquba city from the period of 20 th Septembers, 2016 up to 20 th March, 2017, by selecting a sample of (120) patients by using a structured questionnaire, the questionnaire composed of three parts, the first part contains information related to patients' demographic characteristics, the second part contains some information related to diabetic characteristics and the third part of the questionnaire consists of different questions about preventive foot care practices which consist of 14 positive items. Each one of these items must be answered either with (Always, Never or Sometimes). A three levels Likert scale was used to measure the variables. Finally, the data analyzed using SPSS (Ver.18) and the Chisquare was used to find out any association between studied data and preventive foot care practices. P ≤ 0.05 was considered significant in the present study. Results: Out of 120 diabetic patients, (40%) of them were over 60 years, (52.5%) were male patients, about one third (32.5%) were illiterate, most of them (40.8%) had moderate monthly income, majority of them (66.7%) were living in urban areas. Also the current study showed that the patient responses to preventive foot care practices were satisfactory at all studied items, except at the these items "drying my feet after washing, regular use of lotion or oil to moisturizing foot, taking care when clipping my toenail and visiting doctor after foot injury , their responses assessment were unsatisfactory. It was found that (62.5%) of the studied patients had an acceptable and good foot care practices. Conclusions: It concluded from this study that most of the diabetic patients had an acceptable and good foot care practices, and didn't indicates a significant association between the patients' age, gender, residency, duration of disease and previous history of foot ulcer with overall assessment of preventive foot care practices, and there was only significant association with overall assessment of the studied preventive diabetic foot care practices with patients' educational level and monthly income.

Assessment of Awareness About Foot Care Among Diabetic Patients With or Without Foot Ulcer

“…Regarding foot care awareness current study founded that 20% with poor care, 44% with satisfactory and 36% with good awareness, in other study in Iraq 37.5% with poor awareness and 62.6% with good awareness (14) , from India there was two studies one of them founded that 40% with good practiceand 60% with poor practice (17) , other study show 15% with adequate knowledge, 53% with moderate knowledge and 32% is inadequate knowledge (18) , Other two studies from Saudi Arabia the patients with good foot care 77% while 23% for the bad foot care (12) , 53.3% with high level of knowledge and 46.7% with low knowledge (19) but a study from Al Bahrain revealed that good 20.4%, satisfactory 37%, and poor knowledge 42.6% (15) . The analysis of foot care assessment score revealed that 73.3% of the patients inspect their feet and look for any new red spots/cuts/swelling or blisters, in other study from Iraq 59.2% daily self-foot inspection and 17.5% sometimes (14) , 76.9% according to study from Saudi Arabia (13) , in another study from India 62.9% (17) . About 83.3% of patients in this study practicing daily feet washing, a study in Saudi Arabia with 96.3% (13) and 96.6% from Bahrain (15) the Islamic rituals ablution before offering prayers was the participants practicing washing of the feet daily, but the space between toes should be dried.…”

“…Only 40% of patients in this study applying lotion/moisturizer on the top/button of the feet but not between toes, close to other study 48.7% put moisturizing lotion on feet daily (15) but 28.6% regarding study in India (16) .Moisturizing skin with a suitable cream or lotion can restore skin elasticity and softness by improving cell hydration, This unsatisfactory finding might be explained by the fact that the eastern human regarding moisturizing a skin as shameful act, many of people thought that lotion is cosmetic material only. About 64% of the patients trimming toenail straightly and full edges in this study, in other study 61.81% (17) , other study in Iraq 45.8% always tacking care when clipping their toenail but 2.5% sometimes tacking care when clipping their toenail, and 48.3% always not using sharp scissor to nail cutting but 9.2% sometimes using sharp scissor to nail cutting (14) . In this study 82% of the patients knows that they should not walking barefoot and 79.3% wear shoes/slippers both indoors and outdoors, According to study in Bahrain 42.6% walking bare foot (15) , and 39.3% according to study in India (10) , this difference in results because walking bare foot is common in the previously mentioned countries.…”

“…In this study 82% of the patients knows that they should not walking barefoot and 79.3% wear shoes/slippers both indoors and outdoors, According to study in Bahrain 42.6% walking bare foot (15) , and 39.3% according to study in India (10) , this difference in results because walking bare foot is common in the previously mentioned countries. In current study 70.7% of the patients checking inside the footwear before wearing it, 62.5% according to other study in Iraq (14) (8) . Other recommendation about foot care in diabetic patients is to protect and keep the feet away from too hot/ too cold temperature, 75.3% of the patients in this study keeping on this recommendation, in other study 67.5% testing water temperature before using it always and 9.2% sometimes doing this (14) and 87.8% according to other study (8) .…”

“…In current study 70.7% of the patients checking inside the footwear before wearing it, 62.5% according to other study in Iraq (14) (8) . Other recommendation about foot care in diabetic patients is to protect and keep the feet away from too hot/ too cold temperature, 75.3% of the patients in this study keeping on this recommendation, in other study 67.5% testing water temperature before using it always and 9.2% sometimes doing this (14) and 87.8% according to other study (8) . Keeping blood sugar controlled by healthy diet and regular usage of anti-diabetic medication decrease the risk of development of diabetic foot complication, 48.7% of patients in this study mentioned that they keep their blood glucose controlled, in other study from Saudi Arabia where 41.7% (20) , another study show 43.8% of the patients with controlled blood sugar (10) .…”

“…This is a cross sectional study about assessment of awareness about foot care among diabetic patients mean age was (54.96 ± 12.51) years (range 18-85), 60.0% were female and 40.0% male as in other two studies (12,13) , 73.3% from urban resident and 26.7% from rural resident as in other study (14) . In this study 70.0% were none smoker, 15.3% were ex-smoker, 14.7% were smoker this is agree with other two studies (8,15) .…”