title: Personal and treatment factors associated with foot self-care among veterans with diabetes.
abstract: We developed and validated a survey of foot self-care education and behaviors in 772 diabetic patients with high-risk feet at eight Department of Veterans Affairs medical centers. Principal components analysis identified six subscales with satisfactory internal consistency: basic foot-care education, extended foot-care education, basic professional foot care, extended professional foot care, basic foot self-care, and extended foot self-care (alpha = 0.77-0.91). Despite high illness burden, adherence to foot self-care recommendations was less than optimal; only 32.2% of participants reported looking at the bottom of their feet daily. Independent predictors of greater adherence to basic foot self-care practices included African-American or Hispanic background, perceived neuropathy, foot ulcers in the last year, prior amputation (beta = 0.08- 0.12, p < 0.04-0.001), and provision of greater basic and extended education (beta = 0.16, p < 0.004, and beta = 0.15, p < 0.007). The survey subscales can now be used for evaluating foot care and education needs for persons with high-risk feet.
authors.affiliation: Center for Healthcare Knowledge Management, Department of Veterans Affairs (VA) New Jersey Health Care System, East Orange, NJ, USA. johnsto@uwm.edu
authors.forename: Mark V
authors.initials: MV
authors.lastname: Johnston
authors.forename: Leonard
authors.initials: L
authors.lastname: Pogach
authors.forename: Mangala
authors.initials: M
authors.lastname: Rajan
authors.forename: Allison
authors.initials: A
authors.lastname: Mitchinson
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Krein
authors.forename: Kristin
authors.initials: K
authors.lastname: Bonacker
authors.forename: Gayle
authors.initials: G
authors.lastname: Reiber
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003625:Data Collection; D017719:Diabetic Foot / Q000503:physiopathology / Q000628:therapy*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010551:Personality; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014728:Veterans