Study On The High-risk Foot Screening And Foot-care Knowledge And Behavior Of Community Based Diabetic Patients

OBJECTIVE:Diabetic foot is one of the chronic complications of diabetes,it is distal distal nerve abnormalities and distal peripheral peripheral vascular lesions associated with foot infection,ulcers and / or deep tissue damage.The treatment is difficult,long cycle,disability,high mortality.Identificating the high-risk foot of as soon as possible and taking actively measures can prevent or retard the occurrence of diabetic foot.Community is the main unit of diabetic patients,but there is still lacking of the foot-care knowledge and behavior relevanting data,the purpose of this study to understand the community of diabetic patients with high risk of foot and foot care knowledge And the status quo of diabetes mellitus,and to analyze the knowledge and behavior of foot care in patients with high risk of diabetes mellitus and to provide targeted basis for community intervention.METHODS: This study was divided into two phases.The first phase: Based on the International Clinical Consensus of Diabetes Mellitus,the Practical Guide for Diabetes Foot Prevention and Management,and the Chinese version of Diabetes Prevention and Control Guide(2013).By reviewing the literature,the panel discussion identifies the patients with diabetes mellitus Foot care knowledge and behavioral questionnaire entry pool,the use of semi-structured interviews and expert consultation method to form diabetic foot care knowledge and behavioral questionnaires.Using the method of convenience sampling,from April to May 2016,we selected 200 cases of diabetic patients in Baoding city to verify the reliability and validity of the questionnaire.The collected data were analyzed by SPSS19.0 statistical software.Statistical methods used include: independent sample t test,Pearson correlation,Cronbach's alpha coefficient,statistical test level = 0.05.The second stage: Using of convenient sampling method,in July and September 2016,selected a community in Baoding to meet the inclusion and exclusion criteria of 255 patients with diabetes as the object of study.Through the questionnaire survey,medical records and foot screening and other methods to collect the general information of patients,disease-related information,high-risk foot classification data,foot skin and toe status information and patient foot care knowledge and behavioral data.The collected data were analyzed by SPSS19.0 statistical software.Statistical analysis of the data is carried out using the mean,standard deviation,minimum,maximum,median,rate and composition ratio.The statistical methods used in this study include the independent sample t test,the Mann-Whitney U test,Variance analysis,single factor and multivariate logistic analysis,statistical test level = 0.05.The effect of Mann-Whitney U test was calculated using Excel.RESULTS:1.The knowledge questionnaire contains 5 dimensions,33 items eventually.The correlation index of items and the total score is> 0.2,ranging 0.245 ~ 0.744;Calculating the CR values for all the items,the calues ware considered statistically signifcant.The questionnaire Cronbanch's ? coefficient is 0.897,the folding half confidence is 0.887 and the retest reliability is 0.883 two weeks later.The exploratory factor results were 0.812 and the Bartlett spherical test was 3625.748(P <0.001),and the cumulative variance contribution was 71.680%.2.The behavior questionnaire eventually contains four dimensions of 27 items,in addition to "barefoot walking" and "barefoot shoes",all entries and the total score of the correlation coefficient are> 0.2,0.219 ~ 0.685;CR value of each entry,In addition to "barefoot walking","barefoot shoes" and "at least once a year foot examination",all other items P <0.05,the difference was statistically significant.The exploratory factor results were 0.750 and the Bartlett spherical test was 2062.823(P <0.001),and the cumulative variance contribution was 67.465%.3.C ommunity based diabetic patients with high risk of foot screening: community registration of diabetes in a total of 287 cases,to meet the inclusion and exclusion criteria of a total of 255 cases were included.A total of 190 patients with high risk were detected.The detection rate was 74.51%.Among them,154 cases(60.39%)were grade 1,26 cases(10%)were grade 2 and 10 cases(3.92%).A total of 65 patients(25.49%)with low grade of 0 were detected.There were 189 patients(74.12%)with peripheral neuropathy,32 patients(12.55%)with peripheral vascular disease and 132 patients(51.76%).4.Community based diabetic patients mellitus foot care knowledge and behavior status: the study collected 255 The knowledge questionnaire part score is 80.49 ± 11.257.(77.51 ± 9.619)and knowledge of foot cleaning and maintenance(83.31 ± 13.679),knowledge of diabetic foot disease(77.78 ± 16.721),knowledge of risk of foot injury(70.58 ± 13.218),and knowledge of foot injury Footwear and foot examination knowledge(77.82 ± 18.991)score in general.The score of the questionnaires was 61.03 ± 10.430.(77.5 ± 13.218)and the selection behavior of footwear(77.75 ± 11.937)were relatively good;foot cleaning and curing(58.92 ± 16.171)and footwear and foot examination(30.76 ± 20.760)were poor.Conclusion:1.High-risk screening of diabetes mellitus in community: In this study,the high risk of high risk of diabetic patients with high incidence of neuropathy and the main,combined with relatively small number of patients with vascular disease.It is recommended that the community regularly carry out screening of diabetic foot disease,timely detection of patients with potential problems,the early prevention of diabetic foot.2.Community based diabetic patients with foot care knowledge and behavior: Community based diabetic patients with good knowledge but poor behavior relatively.Patient footwear examination knowledge and behavior are very unsatisfactory,the community should strengthen the knowledge of patients in this area of health education,try to avoid because of lack of knowledge and poor behavior of patients with diabetic foot.There is no significant difference in knowledge and behavior scores between patients with different levels of high risk.Indicating that high-risk patients did not show better than the low-risk patients with foot care knowledge and behavior,it is recommended that the community management of chronic disease in the future to strengthen the high risk of diabetic patients with targeted intervention and education,prevention or mitigation of diabetic foot occur.