| Objective:To explore the correlation of diabetes' knowledge,attitudes,self-care activities of type 2 diabetes patients with diabetic foot(DF),and to provide theoretical basis for clinical prevention of DF.Methods:A multicenter cross-sectional study was conducted across China and a total of 5959 patients with type 2 diabetes were selected for this survey during April to July in 2010.The investigation involves the basic data and laboratory data of the patients,and the diabetes attitude scale(DAS-3),knowledge questionnaire(ADKnowl)and self-care activity scale(SDSCA)are used to assess the attitudes towards the disease,mastery of the knowledge and self-care behavior.According to the WHO definition,patients were divided into two groups:diabetic foot group(DF)and no diabetic foot group(NDF).The data were analyzed through descriptive analysis,percentage,chi-square and logistics regression.Results:1.The average age of the DF patients was higher than that of the NDF group(63.3± 13.0 vs 59.31±12.51,P<0.001),and the proportion of males in the DF group was higher than that in the NDF group.2.In DF and NDF group,patients with peripheral vascular lesions accounted for 42.7%and 12.6%respectively,and the ratio of peripheral neuropathy was 61.9%and 21.9%.The proportion of diabetic nephropathy was 37.3%and 13.9%,and the proportion of diabetic retinopathy was 63%and 30%individually.3.Among the subscales of the DAS-3,DF group got higher score than NDF group in Seriousness of type 2 diabetes(3.68±0.50 vs 3.61±0.46,P=0.027)and Psychosocial impact of diabetes(3.88±0.54vs3.79±0.53,P=0.004).4.There are several dimensions of which the score rate have statistically significant differences between DF group and NDF group in the diabetes knowledge scale:diet(67.1%vs 71.9%,P=0.001),therapy(52.9%vs 60.6%,P<0.001)and exercise(60.2%vs 66.4%,P<0.001).The score rate of diet and treatment knowledge in DF group was lower than that in NDF group,and the exercise knowledge score was higher than that of the NDF group.5.In items of SDSCA,DF group got lower score than NDF group in the frequency of compliance with diet(5.46±2.49vs 5.79±2.32,P=0.021),eating lots of fruits and vegetables(4.31 ±2.68 vs 4.87±2.57,P<0.001),eating a high-fat diet(3.23±2.29 vs 3.68±2.32,P=0.002),continuous exercise(4.43±3.01 vs 5.72±2.58,P<0.001),special exercise(3.71 ±2.99 vs 4.65±2.94,P<0.001,soaking foot(4.56±3.11 vs 5.02±2.99,P=0.011);DF group got higher score than NDF group in the frequency of checking foot(4.42±2.81vs 4.01±2.72,P=0.014)and detecting of blood glucose(4.42±2.81 vs 4.01±2.72,P=0.014).6.Logistic regression analysis showed that diabetic peripheral vascular disease,peripheral neuropathy,diabetic nephropathy,diabetic retinopathy are the risk factors of DF,while the diet and treatment knowledge and persistent exercise are protective for DF.Conclusion:1.Male and age are risk factors for DF,suggesting that men and elderly patients are more likely to have DF;2.Patients with diabetic peripheral neuropathy,vascular disease,and diabetic retinopathy have a higher risk of developing DF;3.In the field of the attitude toward the disease,patients with DF have more psychological pressure than NDF patients,suggesting that patients with diabetes need to end on the attitude toward the disease,the right face effect of diabetes and related complications of diabetes,the psychological pressure of patients need to strengthen prevention of DF;4.DF patients know less about diabetes related knowledge than patients without diabetic foot,which suggest that the lack of understanding of the diabetes rise the possibility of DF.It means that diabetes health education plays an important role in the prevention and treatment of DF.Improving the cognitive level of the disease can reduce or delay the occurrence of complications of diabetes;5.Patients with DF have lower ability of self-care in diet,exercise and foot care than NDF patients,suggesting that patients with diabetes should develop a healthy living habits and improve the self-care ability to prevent DF. |
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