A Questionnaire-based Study on Diabetes Foot Ulcers and Foot Care

Introduction

Diabetes has become a life-threatening disease with fatal, disabling, and expensive complications, with a shorter life expectancy.^1-2 According to a new report from the International Diabetes Federation, one in 12 adults, or more than 74 million people in India is living with diabetes. The prevalence of diabetes in adults aged 20 to 79 years is predicted to be 10.5% (536.6 million) by 2021 and 12.2% (783.2 million) by 2045. Males and females had the same rate of diabetes, with those aged 70 to 75 years having the most effective rate. Prevalence is forecast to be higher in more urban areas (12.1%) than in rural areas (8.3%) in 2021 and in high-income countries (11.1%) than in low-income countries (5.5%). Between 2021 and 2045, middle-income countries are expected to experience the greatest relative increase in diabetes prevalence (21.1%), followed by highincome countries (12.2%) and low-income countries (11.9%).³ Among people with diabetes, 15% of patients are expected to suffer from foot ulcers which are the major causes of hospitalization and prolonged stay in hospital.⁴ Patients living in low-income and developing countries often present to healthcare facilities late with the advanced stage of foot ulcers due to poor economic status, inadequate knowledge of self-care, sociocultural reasons, and inadequate diabetes healthcare.⁵

With the given background the current study was designed to assess the risk factors of diabetes mellitus as well as to assess the knowledge of diabetic foot care among type- 2 diabetes mellitus patients.

Materials and Methods

The current study was conducted among the individuals diagnosed with Type 2 Diabetes Mellitus in Mysuru in a subset of the population of Choranahalli Village, Varuna. The study was approved by the Principal of JSS College of Nursing, Mysuru. One hundred people from rural Mysuru were selected using the Non-probability convenience sampling technique for the study. The inclusion criteria were patients with Type-2 diabetes willing to participate in the study, available at the time of data collection, and can comprehend English or Kannada. Type-2 diabetic patients who are suffering from diabetic ulcers are excluded from the study.

The patients’ demographic parameters such as age, gender, education, duration of illness, previous knowledge, and previous exposure to a diabetic foot ulcer were collected. Then patients’ knowledge regarding diabetic foot care among type-2 diabetic patients was assessed.

Data collection techniques and instruments

Section I:

Personal Proforma was used to evaluate the personal variables.

Section II:

The knowledge scores of type-2 diabetes mellitus patients to evaluate the knowledge regarding diabetic foot ulcer risk factors and diabetic foot care.

Data collection procedure

Hundred Type-2 Diabetes Mellitus patients were recruited for the study. To obtain a free and genuine response, the respondents were explained the purpose and usefulness of the study and the cooperation required from the respondents. Informed consent was taken from each participant, indicating their willingness to participate in the study. The data analysis was planned to include descriptive and inferential statistics. The scores obtained from the samples were tabulated into a master sheet. Mean, median, range, and standard deviation were computed.

Results and Discussion

Among 100 individuals, 61% of participants were more than 50 years of age and 63% were female. Most patients (48%) reported the duration of illness is between 1-10 years and 69% reported previous knowledge of diabetic foot care (Table 1).

Table 2 shows that 49% of type-2 diabetic patients have good knowledge of diabetic foot care, 37% have average knowledge, and only 14% have poor knowledge of diabetic foot care.

The scores obtained from the samples were tabulated into a master sheet. Mean, median, range, and standard deviation were computed. The knowledge score of type2 diabetic patients ranged from 5-25 with a Mean ± SD score of 17.18 ± 4.45. The median score was observed to be 18.

Diabetic foot ulcer risk factors among type-2 diabetic patients were assessed using a checklist, and frequency and percentage were computed. The findings are presented in Table 3.

A statistically significant association was observed between the knowledge of diabetic foot care among type-2 diabetic patients with their selected personal variables. Hence research hypothesis 2 was accepted.

The limitation of the presented study was the less number of sample size limiting the generalization of the findings beyond the study samples and the convenience sampling technique which further limits the generalization of the findings.

A Similar study can be carried out on a larger sample for broader generalization and a comparative study can be performed to assess the risk factors of diabetic foot ulcers and knowledge regarding diabetic foot care among type2 diabetic patients of rural and urban communities.

Conclusion

The mean score of knowledge of type-2 diabetes patients concerning diabetic foot care is 17.8; the median is 18; SD is ±4.45, ranging from 24 to 5. In the study majority of samples, 49%, had good knowledge, about 37% had average knowledge, and 14% had poor knowledge regarding diabetic foot care. The findings of the study revealed a statistically significant association between the knowledge of type-2 diabetic patients regarding diabetic foot care with their selected personnel variable. Hence the research hypothesis H2 was accepted.

Conflict of Interest

Nil

Source of Funding

Funded by RGUHS Bangaluru

Ethical Clearance

Ethical clearance is obtained from JSS Medical College, Mysuru

Acknowledgment

This study was conducted by Ms Theresa Joseph, Sr Theresa AV, Ms Tesa Mathew. Ms. Tenzin Tsering and Ms Varshini S of 4 year BSc(N) students of JSS College of Nursing, Mysuru under the guidance of Mrs Purohit Saraswati Assistant Lecturer, JSS College of Nursing, Mysuru.