KNOWLEDGE, PRACTICE AND BARRIERS OF DIABETIC FOOT SELF-CARE AMONG INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS

Carvalho Neto, Francisco João de; Silva, Antônia Fabiana Rodrigues da; Guimarães, Mayla Rosa; Lima, Emanuel Wellington Costa; Lima, Rafaela Pereira; Silva, Ana Roberta Vilarouca da

doi:10.5380/ce.v27i0.87105

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87105 copy

KNOWLEDGE, PRACTICE AND BARRIERS OF DIABETIC FOOT SELF-CARE AMONG INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To relate knowledge, practice and barriers of diabetic foot self-care among people with Type 2 Diabetes Mellitus, according to gender and education.

Method:

Analytical cross-sectional study with 102 users of 4 basic units in the inland of the state of Piauí, Brazil. Socioeconomic and clinical data were collected between December 2018 and July 2019. Descriptive analysis was performed with the use of the Chi-square test.

Results:

Women showed greater knowledge and practice of moisturizing (p<0.001), drying between the toes after bathing (p=0.020), foot hydration with moisturizing creams/oils on the heels (p<0.001), hydration on the sole of the foot (p=0.003) and use of soft and closed-toed shoes (p=0.001); there was frequent use of socks by men (p<0.001) and they were mostly made of cotton (p<0.001). There was an association between educational level and the use of shoes with heels >5cm (p=0.001) and <5cm (p<0.001).

Conclusion:

It is hoped that this study will allow a new type of approach aimed to the improvement of diabetic foot self-care.

DESCRIPTORS:
Diabetic foot; Type 2 Diabetes Mellitus; Complications of Diabetes; Self-care; Knowledge

Variables	n	%
What do you do to take care of your feet?
Wash	102	100
Dry	77	75.5
Moisturize	61	59. 8
Massage	05	4.9
How often do you wash your feet?
Never	02	2.4
Once a day	10	9.8
Twice a day	20	19. 6
More than twice	70	68. 6
Do you dry the interdigital spaces between the toes
Yes	38	37.3
No	64	62.7
Do you know any kind of home care for feet?
Use of cold substances	08	7. 8
Use of hot substances	11	10. 8
Remedies for calluses	-	-
Plants	03	2. 9
Others	102	100
Type, shape and material of shoes that can be worn by a diabetic person
Type	24	23.5
Shape	08	7.8
Material	12	11.8
What shoes do you usually wear?
Open- sandal type	94	92. 2
Soft, closed-toed	52	51
Heel higher than 5 cm	02	2
Heel height less than 5 cm	04	3.9
No heel at all	79	77.5
You inspect your shoes before wearing them
Always	46	45. 1
Sometimes	24	23.5
Rarely	10	9. 8
Never	22	21.6
You usually clean your shoes
Always	56	54.9
Sometimes	31	30.3
Rarely	7,0	6.9
Never	01	0.9
Other	7	6.8
Do you often cut your nails?
Yes	101	99
No	01	1
What is your nail cut?
Rounded shape	78	76.5
Straight line	24	23.5
What is the instrument used to cut the nails?
Tipped scissor	48	47.1
Blunt scissor	05	4.9
Pocket knife	51	50
Others	11	10. 8
Do you usually wear socks?
Always	16	15.7
Sometimes	26	25.5
Rarely	09	8.8
Never	51	50
Fabric of the socks
Wool	02	2
Cotton	38	37. 3
Synthetic	08	7.8
Other	54	53.2
Do you perform self-assessment of the feet?
Yes	74	72.5
No	28	27. 5
How often do you check your feet?
Always	24	23. 5
Sometimes	43	42.2
Rarely	6	5.9
Never	27	26. 5
When your remember that it is necessary	02	2

Variables	GENDER
	M		M		p^{^* * Chi-square test} value
	n	%	n	%	p^{^* * Chi-square test} value
Washes	72	70.6	30	29.4	^* * Chi-square test
Dries	55	53.9	22	21.6	0.744
Moisturizes	53	52. 0	08	7.8	< 0. 001
Massages	04	3.9	01	01	0.636
How often the individual washes his/her feet
Never	01	01	01	01	0.303
Once a day	05	4. 9	05	4.9
Twice a day	13	12. 7	07	6. 9
More than twice a day	53	52.0	17	16. 7
Dries the feet after bathing	54	52. 9	22	21.6	0. 860
Dries the interdigital spaces between the toes after bathing	32	31.4	6. 0	5.9	0. 020
Applies moisturizers (creams or oils) on the heels	52	51.0	8.0	7.0	< 0.001
Applies moisturizer on the foot sole	35	34.3	5.0	4.9	0.003
Inspects the inside of shoes before wearing them	29	28.4	16	15.7	0. 226
Always cuts the nails straight	19	18. 6	4.0	3. 9	0. 151
Cuts the nails with blunt scissors	3.0	2.9	1.0	1. 0	0. 843
Makes use of a moisturizer for the feet?
Yes	39	38.2	05	4. 9	< 0.001
No	19	18.6	22	21. 6
Knows the type of footwear
Yes	16	15. 7	08	7. 8	0. 630
No	56	54. 9	22	21. 6	0. 630
Knows the shape of the footwear (shoes)
Yes	05	4.9	03	2. 9	0. 601
No	67	65. 7	27	26. 5	0. 601
Regarding the footwear: knows the material the shoes are made of
Yes	05	4.9	07	6.9	0. 019
No	67	65.7	23	22. 5
Shoes commonly used
Open, of sandal type	69	67.6	25	24.5	0. 032
Closed-toed and soft	29	28.4	23	22.5	0.001
No heels	62	60.8	17	16.7	0. 001
Others	04	3.9	07	6. 9	0.008
Usually wears socks
Always	05	4.9	11	10.8	< 0. 001
Sometimes	13	12.7	13	12.7
Rarely	17	16.9	02	02
Never	47	46.1	04	3.9
Fabric of the socks
Wool	01	01	01	01	<0. 001
Cotton	17	16.7	21	20.6
Synthetic	04	04	04	3.9
Others	50	49	04	3.9

Variables	Education
	Illiterate		Complete Primary Education		Secondary Education		Incomplete Higher Education		Complete Higher Education		P value ^* * Chi square test.
	n	%	n	%	n	%	n	%	n	%	P value ^* * Chi square test.
Washes	36	35. 3	44	43. 1	16	15. 7	03	2.9	03	2. 9	^ Test calculation is impossible
Dries	25	24.5	32	31. 4	15	14. 7	02	02	03	2. 9	0. 300
Moisturizes	20	19. 6	28	27. 5	08	7. 8	02	02	03	2. 9	0. 516
Massages	02	02	02	02	-	-	-	-	01	01	0. 183
Regarding the footwear, knows the shape
Yes	04	3.9	01	01	03	2. 9	-	-	-	-	0. 234
No	32	31. 4	43	42. 2	13	12. 7	03	2. 9	03	2. 9	0. 234
Regarding the footwear, knows the material shoes are made of
Yes	04	3. 9	04	3.9	04	3. 9	-	-	-	-	0. 431
No	32	31. 4	40	39. 2	12	11. 8	03	2. 9	03	2. 9	0. 431
Shoes commonly used
Open-of sandal type	14	33. 3	41	40. 2	13	12. 7	03	2.9	03	03	0.483
Closed-toed and soft	16	15.7	23	22. 5	10	9.8	01	01	02	02	0.706
Heel higher than 5 cm	-	-	-	-	01	01	-	-	01	01	0. 001
Heel less than 5 cm	-	-	01	01	01	01	-	-	02	02	< 0. 001
No heel	32	31. 4	34	33. 3	09	8.8	03	2. 9	01	01	0. 026
Usually cleans the footwear
Always	21	20, 6	24	23. 5	07	6. 9	01	01	03	2. 9	0.014
Sometimes	14	13. 7	17	16. 7	07	6. 9	-	-	-	-
Rarely	-	-	03	2.9	02	02	02	02	-	-
Instrument used to cut the nails
Tipped scissors	15	14. 7	22	21.6	9	8. 8	01	01	01	01	0.814
Blunt scissors	01	01	-	-	3.0	2. 95	01	01	-	-	0. 006
Pocket knife	19	18.6	25	24. 5	5.0	4. 9	-	-	02	02	0. 164
Others	04	3.9	03	2. 9	03	2.9	01	01	-	-	0. 444
Cuts nails with blunt scissors	01	01	-	-	01	01	01	01	-	-	0. 017

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Carvalho Neto FJ de, Silva ARV da, Lima EWC, Lima RP; Drafting the work or revising it critically for important intellectual content - Carvalho Neto FJ de, Guimarães MR, Silva ARV da; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Silva ARV da. All authors approved the final version of the text.