Title : Knowledge, attitudes, and practices among patients with diabetes about diabetic foot disease in Khartoum state primary health care centers, November 2022
Abstract:
Introduction: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%.
Aim: This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among patients with diabetes in Sudan.
Methods: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centres in Khartoum, Sudan, during September to November 2022, information regarding participants socio- demographic status, foot care knowledge, attitudes, and practices was gathered
using a validated, structured questionnaire from previous studies(2),(3),(4) in a face- to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS).
Results: The patients mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years, 47% were on insulin medication, and 48% checked their HBA1C every 3 months. On the topic of foot care, 35.5% of patients showed good knowledge, 32% knew the importance of observing feet every day and not only when there's change, 85% admitted they should examine inside footwear for any object before wearing it, and 40% knew the ideal footwear. Of the participants, 76% were aware of the risk of reduced foot sensation, and 88% knew about the susceptibility to foot ulcers among patients with diabetes. In relation to nail care, only 19% knew how to cut nails correctly in straight shape. Regarding attitudes, the majority of patients had favorable attitudes towards diabetic feet; 68% of the study population answered positively when asked if they would go to a podiatrist and follow their advice; and 83% were aware of the importance of diabetes medications in decreasing the complications of disease. In terms of practice, 73% of study population washed their feet daily, 52% dried the cleft between toes after washing their foot, but only 27% performed a daily self-foot examination, and 65% reported inadequate footwear. The mean scores for knowledge, attitudes, and practices were 2.06, 1.22, and 1.67, respectively. Foot care knowledge was significantly correlated with foot self-care practices (p<0.05)
Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.
