Purpose. We conducted a study to assess the prevalence of foot self-check performed by diabetic patients in an urban minority population. To achieve that goal, we used a Diabetes Knowledge Test (DKT) and a Self-Care Activity Assessment questionnaire.
Methods. During the period of enrollment from April 1, 2005, to August 31, 2006, the research nurse administered the Diabetes Knowledge Test and the Self-Care Activity Assessment questionnaire to 463 subjects. Patients who completed a questionnaire also provided a self-report of their socio-demographics and their living status, and their medical information was reviewed. The 23-item Diabetes Knowledge Test included 14 multiple-choice questions pertaining to diabetic health such as diet, exercise, diabetes-related medical conditions, and insulin. Besides questions on knowledge, some questions also pertained to self-care. The test score was calculated as the sum of correct answers to the multiple-choice test items that assessed diabetes-related knowledge.
Results. The sample scored an average of 5.74 on the general Diabetes Knowledge Test. The score was based on the sum of correct answers to the 14 multiple-choice questions. The maximum score was 14. Women’s scores were statistically significantly higher (5.93) than those of the men (5.37) at alpha 0.05, and Caucasians’ scores (6.03) were higher than those of African-Americans (5.72). When patients were asked how many times in the last seven days they had checked their feet, 89% responded they had checked at least once. Patients who reported at least one day of foot care within the previous seven days had higher scores on the Diabetes Knowledge Test than patients who reported no foot care. Diabetes knowledge was positively correlated with the frequency of foot care. African-Americans were 7% less likely than Caucasians (significant at alpha 0.05) to engage frequently in foot care activities after we controlled for patients’ age, sex, and smoking.
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Conclusion. The frequency of foot self-check, a strong predictor of optimal diabetes outcomes, is highly associated with general diabetes awareness. Foot self-check is less prevalent among men and African-Americans. It seems apparent that the medical community could assist in modifying health behavior for populations at risk. It is important for patients to engage in their own foot self-check, perhaps with the assistance of intensive educational programs or other ways of care, including follow-up interventions that target high-risk patients.