Development a model of the foot self-care behavior in patients with diabetic peripheral neuropathy
| Autor: | Yen Fan Chin, 靳燕芬 |
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| Rok vydání: | 2013 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 101 Identification of the factors affecting the foot self-care behaviors of diabetic individuals can be helpful in designing foot-care promotion strategies for diabetic patients. However, such evidence-based data is rare. The purposes of this study were to explore the predictors of foot-care behaviors and to test the model fit of a proposed prediction model for diabetic foot-care behaviors. A cross-sectional design was utilized. Two hundred and ninety-five patients with diabetic neuropathy were recruited from March 1, 2010, to May 31, 2011. Data were collected using the Smilkstein (1978) Family APGAR, the fear thermometer, and four questionnaires designed by the researcher (specifically, a diabetes foot self-care behavior scale, a diabetes foot self-care knowledge scale, a diabetes foot self-care self-efficacy scale, and a diabetic foot ulcer health belief scale). The multiple regression and structural equation model were used to analyze the data. The results showed that the following factors were associated with better diabetic foot-care behavior: Higher foot-care self-efficacy, having had the foot examined by a clinician, having received advice on taking care of the foot, fewer foot-care barrier beliefs, having received foot care education, and lower limb amputation. The above six predictors explained 31.1% of the variance in foot-care behavior. Among them, the foot-care self-efficacy was the most powerful predictor, explaining 14.4% of the variance in foot-care behavior. The proposed prediction model had a poor model fit. After modification, the fitting index were improved (root mean square error of approximation = .068, CMIN/DF = 2.379, comparative fit index = .897, normal fit index = .837, goodness-of-fit index = .908, and adjusted goodness-of-fit index = .873). According to the modified model, the foot-care self-efficacy indirectly influences foot-care behaviors by influencing the foot ulcer threat beliefs. Family support indirectly influences foot-care behaviors by influencing the “foot-care benefit beliefs minus barrier beliefs”. Foot-care knowledge indirectly influences foot-care behaviors by influencing the “foot-care benefit beliefs minus barrier beliefs” and foot ulcer threat beliefs. In this study, foot-care self-efficacy was found to be the most powerful predictor of foot-care behavior in the regression model. We suggest that in order to promote patients’ foot-care behaviors, clinicians should promote patient foot-care self-efficacy by providing mental support to relieve patients’ negative emotions regarding foot care and by establishing patients’ successful experiences in foot self-care. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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