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Diabetes Foot Self-care Practices in a Rural, Triethnic Population

From the Department of Public Health Sciences (Drs Bell, Snively, and Quandt; Ms Smith; Ms Stafford), the Department of Family and Community Medicine (Dr Arcury), and the Physician Assistant Program (Mr Dohanish), Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Correspondence to Ronny A. Bell, PhD, MS, Department of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1063 (rbell{at}wfubmc.edu).

Purpose

The purposes of this study were to assess the level of foot self-care performed in a rural, multiethnic population of older adults and to identify factors associated with foot self-care.

Methods

The Evaluating Long-term Diabetes Self-management Among Elder Rural Adults study included a random sample of 701 African American, Native American, and white adults from 2 rural North Carolina counties. Participants completed in-home interviews, 5 foot self-care practices from the Summary of Diabetes Self-Care Activities (SDSCA), functional status measures, and measures of education and support for foot care.

Results

Foot care practices/behaviors reported at least 6 days/week ranged from 35.6% for inspecting shoes to 79.2% for not soaking feet. Four independent predictors of the SDSCA summary foot care index score were observed: having been shown how to care for feet (P < .0001), female gender (P = .03), having had a doctor check nerves in feet in past year (P = .02), and not receiving support caring for feet (P = .0425).

Conclusions

These findings indicate that educating patients about foot self-care may encourage routine foot care but that those dependent on either formal or informal support to perform foot care do so less frequently than those who perform it independently.

The Diabetes Educator, Vol. 31, No. 1, 75-83 (2005)
DOI: 10.1177/0145721704272859


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