Diabetic foot care: Knowledge and practice – A cross-sectional study from a tertiary care hospital in Southern India

Abstract

Background: Diabetes mellitus is one of the major problems in health systems and a global public health threat and diabetic foot ulcers and lower extremity amputations are common, complex, costly, and disabling complications of diabetes. Poor foot care knowledge and practices are important risk factors for foot-related problems among diabetic people. Aims: The aim of the study is to assess the knowledge about foot care, foot care practices, the prevalence and risk factors of diabetic foot and foot-related complications in adult diabetic patients. Settings and Design: The cross-sectional study was conducted in 204 consecutive diabetic patients attending the outpatient department of a tertiary care hospital. Methods: A questionnaire including demographic details, knowledge questionnaire, attitude, and awareness for foot problems based on the Nottingham Assessment of Functional Foot Care Revised 2015 questionnaire was administered. This was followed by a foot examination for various aspects related to foot care and risk stratification. Statistical Analysis Used: Descriptive analysis with frequency distribution for knowledge and practice scores, univariate analysis, and multiple logistic regressions to find significant variables associated with good foot care knowledge and practice scores. Results: About 30.39% had good knowledge score. Rural background (adjusted odds ratio [OR]: 1.98, 95% confidence interval [CI]: 1.08–3.65), poor education status (adjusted OR: 4.63, 95% CI: 1.04–20.54), poor glycemic control (adjusted OR: 1.46, 95% CI: 0.83–2.58), and previous history of foot ulcer (adjusted OR: 3.05, 95% CI: 1.42–6.65) were significantly associated with poor knowledge on foot care. Conclusion: Our study shows that knowledge and practice of foot care of diabetic patients are still substandard. Poor communication between patients and nurses/physicians, rural background, poor education, and poor glycemic control were significant barriers of foot care. Policymakers should initiate foot care education programs throughout the regional state for increasing awareness about proper foot care practice in diabetic patients to reduce the incidence of complications.