Knowledge and Practice of Foot Care in People with Diabetes

Aim: To determine knowledge and practice of foot care in people with diabetes.

Methods: A questionnaire was completed by patients in Middlesbrough, South Tees, UK. A knowledge score was calculated and current practice determined. Practices that put patients at risk of developing foot ulcers and barriers to good practice were identified. Patients at high risk of ulceration were compared to those at low risk.

Results: The mean knowledge score was 6.5 (S.D. 2.1) out of a possible 11. There was a positive correlation between the score and having received advice on foot care (6.9 versus 5.4, P = 0.001). Deficiencies in knowledge included the inability to sense minor injury to the feet (47.3%), proneness to ulceration (52.4%) and effect of smoking on the circulation (44.5%). 24.6% (20.1-29.2) never visited a chiropodist, 18.5% (14.2-22.7) failed to inspect their feet and 83% (79.1-86.9) did not have their feet measured when they last purchased shoes. Practices that put patients at risk included use of direct forms of heat on the feet and walking barefoot. Barriers to practice of foot care were mainly due to co-morbidity. Those with high risk feet showed a higher (6.8) but not significant knowledge score compared to those at low risk (6.5) and their foot care practise was better.

Conclusion: The results highlight areas where efforts to improve knowledge and practice may contribute to the prevention of foot ulcers and amputation.