Knowledge and Practice of Foot Self-Care and Assessment of Foot-At-Risk among Adult Diabetic Patients Attending Two Teaching Hospitals in Enugu State

Abstract

Diabetic foot ulcer which occurs as a result of poorly managed diabetes mellitus constitutes an increasing public health problem especially to those living in Sub-Saharan Africa. This study assessed the knowledge, practice of foot self-care and foot-at-risk of ulceration, among adult diabetics being managed at two teaching hospitals in Enugu State, Nigeria. The study adopted a descriptive cross sectional survey design. 202 and 112 patients respectively were proportionately and purposively recruited for the study from the two teaching hospitals. Data collection was done using three instruments: a 47 item researcher developed questionnaire used to solicit information on respondents characteristics, knowledge and self-reported practice of foot self-care, a Standardized tool “60 seconds screening tool” used to assess foot-at-risk of ulceration as well as the common foot abnormalities observed in the respondents and an observation checklist used to validate the self-reported foot self-care practices. The instruments were face and content validated while reliability of the instrument was carried out using test re-test method and Pearson’s Moment Correlation Statistics. Data collected for the study were analyzed with the help of percentages and mean for descriptive statistics IBM SPSS version 20 and Pearson’s Moment Correlation for inferential statistics at 0.05 level of significance. Results of this study showed that 16.9% had good knowledge, 68.5% had average, while 14.6% of the respondents had poor knowledge of foot self-care. Reported foot self-care practices was poor 9.9%, while on observation, 28.7% respondents had appropriate foot wears. The respondents at risk of diabetic foot ulceration were 42.7%. The common foot problems identified were foot deformity (36.6%), linear cracks (19.1%) and active ulcer or blisters (15.6%). Smoking and eye complication were associated with higher risk of developing foot ulceration (P< 0.05). The younger the patients, the better the knowledge and practice of foot self-care while being gainfully employed and prior diabetic foot education were found to increase diabetic foot self-care practice (P< 0.05). Respondents who had good knowledge had also good practice of foot self-care (P = 0.000 ~0.001). Conclusion and recommendation: instituting supportive-educative system of intervention could improve patients’ knowledge and foot care practices.