Diabetic Patients’ Knowledge and Practice Regarding Prevention of Diabetic Foot
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- Category: Vol. 81, March 2013
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Diabetic Patients’ Knowledge and Practice Regarding Prevention of Diabetic Foot,ALI S. ALASMARY, OSSAMA A. MOSTAFA and YAHIA M. AL-KHALDI
Abstract
Aim of Study: To assess knowledge and practice of diabetic patients as regard their feet care.
Patients and Methods: This study was conducted at three primary health care centers (PHCCs) in Abha City, Kingdom of Saudi Arabia. A total of 432 diabetic patients were included in the present study sample which represented 25% of all registered diabetics in these three PHCCs. An interview questionnaire and a feet examination sheet were used.
Results: More than half of patients suffered from hotness sensation in their feet (54.2%). Feet numbness was complained by 47.7% of patients, while feet tingling was complained by 37.7%. Good fasting blood sugar control was achieved only in 14.1% of diabetic patients. Only 41.4% of patients underwent feet examination by primary health care (PHC) physicians. One third of patients received educational brochures about foot care, while health education sessions on importance of and how to conduct foot care have been held only for 43.1% of patients. Some patients had abnormal color of feet skin (14.4%), nails abnormalities (12.7%), swelling (6.9%), defor-mity (7.4%), muscle atrophy (6%), foot skin cracks (10.2%), callus (6.9%) and amputation (1.4%). Palpation revealed temperature fluctuation occurred in 1.4% of cases, absent dorsalis pedis pulse (7.2%) or posterior tibial pulse (17.6%) and absent capillary refill (15.3%). There were diminished/lost vibration sense (12.3%), impaired sense of pressure (18.8%) and impaired Achilles tendon reflex (17.6%).
Conclusions: Most diabetics do not receive the necessary educational materials about foot self-care and health education sessions on importance of and how to conduct foot care. PHC physicians do not provide the required routine foot examination to diabetic patients. Diabetic patients' knowledge and practices regarding diabetic foot care are generally unsatisfactory. Diabetics who have the least knowledge scores are those who are within the age group <40 years, females, non-married, illiterates, unemployed, type 2 diabetic patients, duration of diabetes less than 10 years, and those with bad fasting blood sugar control.
Recommendations: Diabetic patients should receive health education covering all items related to prevention of diabetic foot and diabetic foot self-care. They should be encouraged to practice steps of self-care. A Special emphasis should be directed to: Females, illiterate, with recent diagnosis of diabetes. Diabetic patients with intact protective sensation and peripheral pulse should receive routine foot examination at least once/year. Patients with lost protective sensation and/or foot deformity are to be managed by a family physician and a diabetologist every 3-6 months. Diabetics with lost protective sensation or peripheral arterial disease or with a history of ulcer or amputation should be referred to a podiatrist or a specialty clinic and to be seen every 1-3 months. PHC physicians should receive training to provide ideal and proper routine foot examination and health education sessions to diabetic patients.