Factors Influencing Daily Foot Care Behaviors Among Diabetic Persons with Peripheral Neuropathy in a Community

Abstract

          Peripheral neuropathy is considered a risk factor for diabetic foot ulcers. The practice of daily foot care behavior depends on several individual and family factors. This predictive correlational research used the Becker and Rosenstock Health Belief Model. The objectives of the study were to 1) examine daily foot care behaviors of persons with diabetic peripheral neuropathy; 2) determine the relationship between perceived susceptibility to foot amputation, perceived seriousness of foot amputation, perceived benefits of foot care practice, perceived barriers to foot care practice, awareness of diabetic peripheral neuropathy, receiving recommendations from healthcare providers, knowledge about foot care practice, level of diabetic peripheral neuropathy, perceived self-efficacy, family support, and daily foot care behaviors; and 3) identify factors influencing daily foot care behaviors among persons with diabetic peripheral neuropathy. One hundred and eighteen persons with diabetic peripheral neuropathy were recruited from an outpatient clinic at Saraphi Hospital. Research instruments consisted of general information, the Daily Foot Care Behavior Scale, knowledge about foot care practice, the Diabetic Foot Ulcer Health Belief Scale, the Foot Care Confidence Scale, and the Family Support Scale. The content validity was evaluated by a panel of experts; content validity indices ranged from 0.81-1.00, and internal consistency coefficients ranged from 0.81-0.90. Data were analyzed using descriptive statistics, Spearman’s rho correlation, and the Mann-Whitney U test, including logistic regression.
          The study results revealed the following:
           1. The practice of daily foot care behaviors among participants was relatively high, ranging from 13 to 36 ("X" ̅ = 29.72, SD = 4.50).
           2. Perceived susceptibility to foot amputation, perceived barriers to foot care practice, knowledge about foot care practice, perceived self–efficacy, and family support were slightly correlated with daily foot care behaviors. (r = 0.243, p < 0.01; r = -0.249, p < 0.01; r = 0.193, p < 0.05; r = 0.289, p < 0.01, and r = 0.191, p < 0.05, respectively). Also, receiving or not receiving foot care recommendations from health care providers affected daily foot care behaviors differently (U = 846, p < 0.05).
           3. Receiving recommendations from healthcare providers and perceived susceptibility to foot amputation were found to be significantly associated with daily foot care behaviors (OR = 6.57, 95% CI = 2.19 - 19.74 and OR = 2.06, 95% CI =1.14 - 3.72, respectively).
             The results from this study can provide guidelines for health care providers, including local and national healthcare policymakers, to design healthcare services to promote the practice of daily foot care behaviors for persons with diabetic peripheral neuropathy in the community setting.