Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study.

Taiwo Maxwell Adeyemi,Ademola Emmanuel Adetunji,Satwinder Rehal,Tomi Lois Olatunji

doi:10.3390/ijerph18158021

Abstract

Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants’ knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.

Highlights

IntroductionDiabetes is one of the major public health problems in the world, responsible for several health problems, including stroke, blindness, heart attack, kidney failure, and lower limb amputation [1]
A qualitative exploratory descriptive design was adopted for the study to explore the knowledge, attitude, and practice of adults with diabetes about foot ulcers and foot care in Tobago
In terms of the main outcome on the participants’ knowledge regarding diabetic foot ulcer (DFU), this study revealed that participants had poor knowledge of DFU, signs of DFU, and the relationship of diabetes with regards to DFU

Summary

Introduction

Diabetes is one of the major public health problems in the world, responsible for several health problems, including stroke, blindness, heart attack, kidney failure, and lower limb amputation [1]. In 2017, diabetes mellitus resulted in the death of 4 million adults globally [2]. In 2019, an estimated 463 million individuals lived with diabetes, with a prevalence level of 9.3% in adults. The prevalence of diabetes has increased by 62% over the last ten years (2009–2019), and the prevalence is projected to rise to 10.2% and 10.9% by 2030 and 2045, respectively [3]

Methods

Results

Discussion

Conclusion