The Behaviours of Foot Self-monitoring in Patients with Diabetes Mellitus and Its Relating Factors

Autor: Li-Ching Lin, 林俐菁
Rok vydání: 2018
Druh dokumentu: 學位論文 ; thesis
Popis: 106
The recurrence of foot ulcer in patients with diabetes that leads to amputation is a tragedy for patients, health professionals, and the society. Thus, self-monitoring is a crucial measure of diabetic foot care. Understanding patients’ self-monitoring of foot health and relating factors of foot ulcer helps health professionals to enhance patients’ awareness of the disease. This study investigated the behaviours of foot self-monitoring in patients with Diabetes Mellitus and its relating factors. A descriptive correlational research design was adopted, and a self-designed scale was used to investigate the patients’ self-monitoring knowledge of foot health as well as their attitude toward this topic and actual behaviours. Purposive sampling was performed to recruit 100 patients, who were either interviewed or asked to fill in the questionnaire. The collected data were analysed using independent t tests, one-way analysis of variance, Pearson’s correlation analysis, and multivariate hierarchical regression. The demographic data of the 100 hospitalized diabetic patients are as follows: the sex ratio was 1:0.8 (male: female), and the average age was 61.56 years old. Most of the patients had an educational level of elementary school, had developed diabetes for an average of 16.75 years, and were mostly diagnosed with Type 2 diabetes. Less than half of the patients had received instructions regarding diabetic foot self-monitoring; more than half of the patients had experienced foot ulcer after being diagnosed with diabetes, and one third of the patients had foot ulcer when participating in this research. The average score for the knowledge of foot self-monitoring was 12.97 (standard deviation [SD] = 4.90), with a total score of 19; thus, the correct rate was 68.26%. Specifically, the patients had relatively insufficient knowledge of foot problem screening and recording and were less alerted to neuropathy in feet. The average score of self-monitoring attitude was 49.63 (SD = 7.72), with a total score of 76. The range of the obtained scores was 30–76, indicating a positive attitude toward foot self-monitoring. However, 61% of the participants agreed with the statement that “I feel embarrassed and difficult to ask other people to help me check my foot skin.” The average score of foot self-monitoring behaviour was 12.64 (SD = 9.68), which only reached 28.7% of the total score (44). The obtained scores ranged from 0 to 37, indicating that the patients seldom performed self-monitoring of their foot health. In particular, they had relatively poor performance in “recording the self-monitoring results,” “checking whether the foot skin turned red immediately after taking off the shoes,” and “checking their pedal pulse.” In sum, patients with diabetes had a satisfactory level of foot self-monitoring knowledge and held relatively positive attitude toward foot self-monitoring, but obtained low scores for the self-monitoring behaviour, which indicated their low frequency of performing foot self-monitoring. Significantly positive correlations were observed among the knowledge, attitude, and behaviour of foot self-monitoring. The correlation coefficient for self-monitoring knowledge and behaviour was 0.20, and that for self-monitoring attitude and behaviour was 0.44. The hierarchical regression analysis indicated that the five predictor variables, namely overall foot self-monitoring knowledge, overall foot self-monitoring attitude, educational level (bachelor degree and higher), having received instructions regarding foot self-monitoring, and having performed foot care, together explained 32.8% of the variance of the overall foot self-monitoring behaviour. Moreover, the overall foot self-monitoring knowledge and attitude explained 19.2% of the variance of the overall foot self-monitoring behaviour. However, if the attitude variable was excluded, the explanatory power of the overall foot self-monitoring knowledge for the behaviour was only 0.1% (F = .153, p = .696 > .05). In other words, the multivariate analysis revealed that the overall foot self-monitoring attitude, instead of the overall foot self-monitoring knowledge, was the most significant explanatory variable for the overall foot self-monitoring behaviour. This study concluded that the patients seldom implement foot self-monitoring behaviours. Thus, health education practitioners are suggested to evaluate patients’ self-monitoring ability in advance, examine whether they have difficulty in bending over due to obesity or have poor eyesight, and confirm whether any person can assist the patients in the self-monitoring tasks. In addition, the self-monitoring knowledge and methods should still be emphasised in patient education, such as how to perceive symptoms of neurovascular foot lesions, method of monitoring pulsation, and innovative foot self-monitoring devices, to help the patients identify new ulcer or ulcer recurrence as early as possible. Actual implementation is most critical to maintain a good health condition. Thus, enhancing the attitude of patients at high risk of diabetic foot toward self-monitoring and encouraging them to conduct self-monitoring actions are imperative.
Databáze: Networked Digital Library of Theses & Dissertations
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