Diyabetik Hastaların Diyabetik Ayak ve Ayak Bakımıyla İlgili Bilgi, Tutum ve Davranışlarının Değerlendirilmesi

Abstract

Objectives: To assess the knowledge, attitudes and behaviors of diabetic patients and related factors about diabetic foot (DF) and foot care. Materials and Methods: Patients attended to family medicine out-patient clinics of Keçiören Training and Research Hospital for follow-up and treatment of diabetes (DM) between May-August 2014 were included in this cross-sectional study. Study data were collected by a questionnaire consisting of 56 items that questioned socio-demographic characteristics, knowledge, attitudes and behaviors of patients about diabetic foot (DF) and foot care. Correct answers to the questions were considered ‘1’ point and wrong ones were ‘0’ point. Collected scores were converted to hundred standard scores after the raw scores were calculated. The height, body weight, blood pressure measurements and foot examination of all patients were fulfilled, urea, creatinine, fasting and postprandial blood glucose levels were assessed. Besides the frequencies and percentage distributions, correlation and chi square analysis were used for the evaluation of associations between variables, Mann-Whitney U and Kruskall-Wallis H tests were used for the comparisons of groups. Results: Seventy-nine percentage (n:139) of 176 patients included into the study were women and 21.0% (n:37) were men. Mean age was 58.0±10.6 years. 54.6% (n:96) of the patients had hypertension. There was foot ulcer in 9.7% (n:17), hospitalization for foot ulcer in 3.4% (n:6), operation history in 2.8% (n:5) of the patients. The 45.5% (n:80) of the patients noted that they do regular foot care, 79% (n:139) check their soles regularly, %25.6 (n:45) check inside of shoes before dressed, while 54% (n:95) noted that they walk barefoot in and outside of home.  According to physical examination findings, 50% (n:88) of the patients were found in high risk group for DF. Sixty-five % (n:114) of the participants had not received any education about DM and 90.9% (n:160) about DF and foot care. The 93.8% of the patients who were doing regular foot care and 82.3% of who were not doing stated that diabetic patients should do regular foot care.  The average knowledge score of the patients was 70.6±21.1, attitude and behavior score was 48.1±13.3out of 100. There was a positive correlation between knowledge scores and attitude and behavior scores (p=0.02). Gender, education, education about DM and type of treatment had no effects on knowledge, attitudes and behaviors. Whereas, DM diagnosis time, control frequency and risk status for DF had no effect on knowledge scores; attitude and behavior scores were high in patients who were followed up to 10-20 years, controlled regularly and who had high risk for DF (p=0.007, p=0.04 and p=0.02, respectively). The knowledge, attitude and behavior scores of patients who had another DM patient in the family were higher than the patients without (p=0.003 and p=0.004, respectively).      Conclusion: It was observed that diabetic patients did not receive education about DF and foot care, and also did not practice even if their knowledge was enough. Standardized education about DM and DF should be given to all diabetic patients regularly and implementation of the points should be emphasized in educations be followed up closely.