Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Study Setting
2.3. Study Participants
2.3.1. Inclusion Criteria
- Voluntary consent to participate in the research.
- Ability to speak, read and understand English.
- Adults with diabetes aged 20 years and above with foot ulcers of more than four months who are registered at the lifestyle clinic and diabetes foot clinic and come for dressing at the clinics and/or are patients on admission.
2.3.2. Exclusion Criteria
2.4. Recruitment of Participants
2.5. Ethics
2.6. Data Collection
2.7. Data Analysis
3. Results
3.1. Socio-Demographic Information of Participants
3.2. Emergent Themes
3.3. Foot Ulcer Problems
“I went for a check-up at the clinic, andwhen I got to the health centre, my foot was rubbed too tightly, I had big blood, and it caused the sore. It was bad, but it’s healing”.(DFUP07)
3.4. Knowledge of Diabetic Foot Ulcer
3.4.1. Knowledge of Foot Ulcer
“Well, yes, from time to time, you pick leaflets and other correspondence on foot ulcer at the health centres”.(DFUP04)
“No, when I had foot ulcer, it was very difficult because I did not have much information about it”.(DFUP15)
3.4.2. Knowledge on the Relationship of Diabetes with Foot Ulcers
“When the diabetes ispoorly controlled, you get cracks on the feet, and that can lead to a foot ulcer”.(DFUP01)
3.4.3. Knowledge on Signs of Foot Ulcer
“My foot was swelling, and I realized one day that I woke up, I noticed no skin on top of the toe. The early sign was swelling”.(DFUP20)
3.4.4. Knowledge of Diet and Eating Habits in Preventing Foot Ulcers
“Regular medication, which is compulsory, and your diet and exercise will prevent it”.(DFUP01)
3.4.5. Knowledge on Regular Use of Medication
“Well, when you don’t take your medication regularly, things go bad, the foot may develop deterioration and leads to amputation”.(DFUP16)
3.5. Knowledge of Foot Care
3.5.1. Knowledge of Foot Cleaning Frequency and Foot Inspection
“It should be inspectedevery time you feel dryness on the skin”.(DFUP03)
3.5.2. Knowledge of Bathing and Foot Cleaning Water Temperature
“I feel strange and funny with warm water; I prefer it to be cold in washing my feet”.(DFUP08)
3.5.3. Knowledge on Washing the Feet with Soap and Water, Preventing Feet Irritation after Washing, and Appropriate Foot Cream
“Washing with soap and waterhelps to disinfect your feet and its sores”.(DFUP03)
“Well, after washing, you need to dry your foot and apply foot powder and put in socks to keep your foot dry”.(DFUP15)
“The doctorrecommends paraffin oil, but sometimes I just put Vaseline”.(DFUP08)
3.5.4. Knowledge on Appropriate Footwear, Socks, and Frequency of Changing Socks
“A diabetic patient should wear soft, comfortable shoes made from breathable material”.(DFUP18)
“Well, I don’twear socks, but if I did, I would say socks should be changed every day and should be cotton”.(DFUP01)
3.5.5. Knowledge on the Frequency of Cutting Toenails and Walking Barefooted
“Walking barefooted can cause more damage to your feet if you have foot ulcers; it can become infected and then lead to amputation”.(DFUP01)
3.5.6. Health Education Knowledge on Foot Care and Knowledge Score Rate
“I learn for myself. Yes, I read handouts on everything about diabetes. I learn everything because it relates to me”.(DFUP15)
3.6. Foot Care Practice/Attitude
“All the time, every day. SometimesI can’t reach my foot, but every day I will ask my husband to massage my feet and inspect every part because I can’t see under my foot”.(DFUP15)
“The neuropathologistadvised me to soak my feet in the night. It is not a daily regime; I’m inclined to do it when I feel the numbness; I use water and salt, and I test the temperature”.(DFUP04)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Participant ID | Age | Sex | Ethnicity | Marital Status | Education Level | Employment Status | Income/Month ($) | Years of Living with Diabetes | Length of Time with DFU (Years) | Admitted Patient | Out-Patient | Alcohol | Family History of Diabetes | Smoking |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
DFUP01 | 71 | F | Black | Married | Secondary | Unemployed | 3000–5999 | ˃20 | NA | No | Yes | No | yes | No |
DFUP02 | 61 | F | Black | Married | Tertiary | Retired | ˃10,000 | 10 | NA | No | Yes | No | No | No |
DFUP03 | 44 | F | Black | Married | Secondary | Employed | ˃10,000 | 5–10 | NA | No | Yes | No | Yes | No |
DFUP04 | 65 | M | Black | Married | Secondary | Retired | ˃10,000 | ˃10 | NA | No | Yes | Occasionally | yes | Occasionally |
DFUP05 | 70 | F | Black | Single | Primary | Retired | ˃10,000 | ˃20 | NA | No | Yes | No | Yes | No |
DFUP06 | 62 | F | Black | Married | Tertiary | Employed | ˃10,000 | 4–5 | NA | No | Yes | No | Yes | No |
DFUP07 | 55 | F | Mixed | Married | Secondary | Unemployed | ˂3000 | ˃20 | NA | No | Yes | No | Yes | No |
DFUP08 | 49 | M | Black | Divorced | Primary | Self-employed | ˂3000 | ˃20 | 9 | No | Yes | No | Yes | Yes (10 S/Day) |
DFUP09 | 50 | M | Black | Separated | Secondary | Employed | 3000–5999 | ˃10 | 3 | Yes | No | Yes | Yes | Yes |
DFUP10 | 28 | M | Black | Single | Tertiary | Employed | ˃10,000 | ˃10 | NA | No | Yes | No | yes | No |
DFUP11 | 55 | F | Mixed | Married | Tertiary | Employed | ˃10,000 | ˃10 | NA | No | Yes | Occasionally | yes | No |
DFUP12 | 59 | M | Black | Married | Secondary | Self-employed | ˃10,000 | 4 | NA | No | Yes | No presently, but yes before diabetes | Yes | No |
DFUP13 | 30 | F | Black | Single | Secondary | Employed | 3000–6000 | 9 | NA | No | Yes | sometimes | Yes | No |
DFUP14 | 43 | M | Mixed | Married | Secondary | Employed | ˃10,000 | 6 | NA | No | Yes | Not really | Yes | No |
DFUP15 | 68 | F | Mixed | Married | Secondary | Unemployed | ˂3000 | 25 | 5 | No | Yes | No | Yes | No |
DFUP16 | 67 | F | Black | Married | Primary | Retired | 3000–6000 | 40 | NA | No | Yes | Not at all | No | No |
DFUP17 | 63 | F | Black | Married | tertiary | Employed | ˃10,000 | 5 | NA | No | Yes | Occasionally | Yes | No |
DFUP18 | 46 | M | Black | Married | Tertiary | Employed | ˃10,000 | 20 | NA | No | Yes | No | Yes | No |
DFUP19 | 58 | F | Mixed | Married | Secondary | Retired | ˂3000 | 6 | 4 Months | Yes | No | No | Yes | No |
DFUP20 | 69 | M | Black | Married | Primary | Retired | 5000 | 2 | 1 | Yes | No | No | Yes | Yes (2 Pck/Week) |
Themes | Sub-Themes | Category |
---|---|---|
Knowledge on diabetic foot ulcer |
| |
| ||
| ||
| ||
Knowledge on foot care |
| Daily/Every other day/Once a week |
| Personal inspection/Inspection by spouses or others | |
| ||
| ||
| ||
| ||
| Daily/Every other day/Once a week | |
| Personal cutting of toenail/Professional cutting of toenails | |
| ||
| Treatment application/Drying | |
| Knowledge from attending foot care classes | |
Knowledge from health care professionals | ||
Knowledge from reading handout | ||
| Good, poor, limited. | |
Foot care practice/attitude |
| |
| ||
| ||
| ||
| ||
| ||
| Sandal/Leather/Closed toe/Round toe/Sneakers/Slippers, Flipflop/High heel | |
| Wool/Cotton/Acrylic/Special/Others | |
| ||
| ||
|
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Adeyemi, T.M.; Olatunji, T.L.; Adetunji, A.E.; Rehal, S. Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study. Int. J. Environ. Res. Public Health 2021, 18, 8021. https://doi.org/10.3390/ijerph18158021
Adeyemi TM, Olatunji TL, Adetunji AE, Rehal S. Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study. International Journal of Environmental Research and Public Health. 2021; 18(15):8021. https://doi.org/10.3390/ijerph18158021
Chicago/Turabian StyleAdeyemi, Taiwo Maxwell, Tomi Lois Olatunji, Ademola Emmanuel Adetunji, and Satwinder Rehal. 2021. "Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study" International Journal of Environmental Research and Public Health 18, no. 15: 8021. https://doi.org/10.3390/ijerph18158021