The influence of beliefs about health and illness on foot care in diabetic subjects with severe foot lesions: a comparison of foreign- and Swedish-born individuals

Abstract

Objective: To explore beliefs about health and illness among foreign-born and Swedish diabetic men with severe diabetic foot lesions that might affect self-care and care-seeking behaviour. Design: Explorative study with consecutive sampling. Focus group interviews with 11 Swedish-born men and individual interviews with 15 foreign-born men, aged 38–74 years (mainly Europeans) with present or previous diabetic foot lesions. Results: Foreign-born men often attributed the ulcer to work-related accidents outside their control, perceived the occurrence of an ulcer as a trifle, stated lack of information about foot care and management of diabetes, showed passive self-care behaviour and visited health professionals when they had new foot problems. Swedes discussed more foot problems, expressed great fears and anxiety when having an ulcer, had a higher degree of knowledge about foot care, showed active self-care behaviour and tried to prevent foot ulcers. In both groups foot lesions caused deterioration of perceived health and quality of life due to decreased level and ability to be active. Conclusion: Beliefs about health and illness differed between foreign- and Swedish-born men and affected self-care and care-seeking behaviour. Their beliefs need to be considered in prevention and management of the diabetic foot. Many patients, especially foreign-born, have an underutilised potential for self-care measures.