Association between knowledge and adherence to foot self-care practices performed by diabetics

doi:10.1590/0034-7167-2019-0430

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (5) • 2020 • https://doi.org/10.1590/0034-7167-2019-0430 copy

Association between knowledge and adherence to foot self-care practices performed by diabetics

Asociación entre conocimiento y adherencia a las prácticas de autocuidado con los pies realizadas por diabéticos

About the SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to verify the association between knowledge and adherence to foot self-care practices performed by patients with diabetes mellitus type 2.

Methods:

cross-sectional, descriptive study carried out with 197 patients in basic health units located in the Northeast region of Brazil. For data collection, we used a semi-structured questionnaire that addressed issues inherent to knowledge and Diabetes Self-Care Activities.

Results:

we observed that patients with moderate knowledge about self-care practices were more likely to perform foot self-examination, dry the interdigital spaces, moisturize their feet with creams and oils, observe the presence of mycosis and ingrown toenail when compared to patients with insufficient knowledge.

Conclusions:

the patients' level of knowledge was closely related to the self-care activities carried out, which reinforces the importance of nurses working on training those on essential health care.

Descriptors:
Diabetes Mellitus; Knowledge; Self-Care; Foot; Nursing

Variables	Knowledge		Total n (%)	p value^* * Chi-square Test.
Variables	Low n(%)	Moderate n(%)	Total n (%)	p value^* * Chi-square Test.
Gender
Female	103 (79.8)	26 (20.2)	129 (65.5)	0.008
Male	64 (94.1)	4 (5.9)	68 (34.5)
Age
≤ 60 years	61 (85.9)	10 (14.1)	71 (36.2)	0.720
> 60 years	105 (84.0)	20 (16.0)	125 (63.8)
Schooling (years of study)
0-4	84 (87.5)	12 (12.5)	96 (52.5)	0.426
5-8	37 (86.0)	6 (14.0)	43 (23.6)
9-12	23 (79.3)	6 (20.7)	29 (15.7)
13 or more	11 (73.3)	4 (26.7)	15 (8.2)
Marital Status
Married	85 (85.0)	15 (15.0)	100 (50.8)	0.836
Widow/widower	46 (82.1)	10 (17.9)	56 (28.4)
Separated/divorced	19 (90.5)	2 (9.5)	21 (10.7)
Single	14 (82.4)	3 (17.6)	17 (8.6)
Civil Union	3 (100)	0 (0.0)	3 (1.5)
Work situation
Inactive	121 (86.4)	19 (13.6)	140 (74.1)	0.253
Active	39 (79.6)	10 (20.4)	49 (25.9)
Income
≤ 1 minimum wage	142 (86.6)	22 (13.4)	164 (90.6)	0.426
> 1 minimum wage	14 (82.4)	3 (17.6)	17 (9.4)
Housing situation
Lives alone	25 (96.2)	1 (3.8)	26 (13.3)	0.061
Do not live alone	140 (82.8)	29 (17.2)	169 (86.7)
General knowledge	167 (84.8)	30 (15.2)	197 (100.0)

Variables	Knowledge		p value^* * Mann-Whitney test.
Variables	Low	Moderate	p value^* * Mann-Whitney test.
In how many of the past seven days did you self-examined your feet	81.05	119.74	< 0.001
In how many of the past seven days have you inspected your shoes before putting them on	96.25	114.32	0.079
In how many of the past seven days have you dried the spaces between your toes after washing them	90.73	134.53	< 0.001
In how many of the past seven days have you walked barefoot	96.72	101.75	0.479
In how many of the past seven days have you done a foot soak	98.14	94.00	0.250
In how many of the past seven days have you used socks to put on closed in shoes	95.87	109.72	0.141
In how many of the past seven days have you moisturized your feet with creams and oils	94.01	116.58	0.024
In how many of the past seven days have you observed the presence of interdigital mycosis	93.19	127.90	< 0.001
In how many of the past seven days have you observed the presence of an ingrown nail	92.49	124.90	0.001

Variables	Knowledge		Total n (%)	OR^* * OR - odds ratio; (95% CI)^† † 95% CI - 95% confidence interval;	p value^* * OR - odds ratio;
Variables	Low	Moderate	Total n (%)		p value^* * OR - odds ratio;
Perform foot self-examination
Yes	40	17	57 (29.2)	5.64 (2.39-13.32)	< 0.001^‡ ‡ Chi-square test;
No	125	13	138 (70.8)	5.64 (2.39-13.32)
Check inside the shoes before putting them on
Yes	82	19	101 (51.3)	1.79 (0.80-3.99)	0.151^‡ ‡ Chi-square test;
No	85	11	96 (48.7)	1.79 (0.80-3.99)
Dry interdigital spaces after washing them
Yes	19	6	25 (26.6)	4.04 (1.11-14.72)	0.036^§ § Fisher's exact test
No	64	5	69 (73.4)	4.04 (1.11-14.72)
Moisturize the feet with creams or oils
Yes	15	3	18 (19.4)	1.67 (0.39-7.07)	0.360^§ § Fisher's exact test
No	67	8	75(80.6)	1.67 (0.39-7.07)
Observe the presence of interdigital mycoses
Yes	12	6	18 (19.2)	4.93 (1.30-18.74)	0.025^§ § Fisher's exact test
No	71	5	76(80.8)	4.93 (1.30-18.74)
Observe the presence of ingrown nail
Yes	10	6	16 (17.4)	8.52 (2.19-33.16)	0.003^§ § Fisher's exact test
No	71	5	76 (82.6)	8.52 (2.19-33.16)
Use socks to put on closed in shoes
Yes	7	1	08 ( 8.6)	1.07 (0.12-9.64)	0.650^§ § Fisher's exact test
No	75	10	85 (91.4)	1.07 (0.12-9.64)
Walk barefoot
Yes	6	3	9(9.7)	4.75 (0.99-22.73)	0.070^§ § Fisher's exact test
No	76	8	84 (90.3)	4.75 (0.99-22.73)
Footwear that usually uses:
Pointy shoes
Yes	1	1	2 (1.0)	5.86 (0.36-96.38)	0.277^§ § Fisher's exact test
No	164	28	192 (99.0)	5.86 (0.36-96.38)
Open shoe sandal type
Yes	130	15	145 (74.4)	0.27 (0.12-0.60)	0.001^‡ ‡ Chi-square test;
No	35	15	50 (25.6)	0.27 (0.12-0.60)
Tight closed in shoes
Yes	7	1	08 (4.1)	0.78 (0.09-6.56)	0.644^§ § Fisher's exact test
No	158	29	187 (95.9)	0.78 (0.09-6.56)
Soft and closed in shoes
Yes	42	16	58 (29.7)	3.35 (1.51-7.44)	0.002^‡ ‡ Chi-square test;
No	123	14	137 (70.3)	3.35 (1.51-7.44)

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[1] Corresponding author: Paula Vitória Costa Gontijo. E-mail: paulagontijo17@hotmail.com