title: The influence of beliefs about health and illness on foot care in ugandan persons with diabetic foot ulcers.
abstract: Diabetes mellitus is becoming pandemic, particularly affecting Sub-Saharan Africa, and the prevalence of complications is increasing. Diabetic foot disorders are a major source of morbidity and disability. Delay in the health care process due to patients' beliefs may have deleterious consequences for limb and life in persons with diabetic foot ulcers. No previous studies of beliefs about health and illness in persons with diabetic foot ulcers living in Africa have been found. The aim of the study was to explore beliefs about health and illness among Ugandans with diabetic foot ulcers that might affect self-care and care seeking behaviour. In an explorative study with consecutive sample semi-structured interviews were held with 14 Ugandan men and women, aged 40-79, with diabetic foot ulcer. Knowledge was limited about causes, management and prevention of diabetic foot ulcers. Foot ulcers were often detected as painful sores, perceived to heal or improve, and led to stress and social isolation due to smell and reduced mobility. Most lacked awareness of the importance of complete daily foot care and seldom practised self-care. Health was described as absence of disease and pain. Many feared future health and related it to contact with nurses in the professional sector from whom they sought information, blood tests and wound dressings and desired better organised diabetes clinics offering health education and more opening hours. Many have an underutilised potential for self-care and need education urgently, delivered in well-organised diabetes clinics working to raise awareness of the threat and prevent foot ulcers.
authors.affiliation: School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden ; Department of Social and Welfare Studies, University of Linköping, Campus Norrköping, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Hjelm
authors.forename: Esther
authors.initials: E
authors.lastname: Beebwa
keywords: Africans; attitudes to health/illness; beliefs about health/illness; care-seeking behaviour; diabetes mellitus complications; foot ulcer; self-care.
references.citation: Diabetes Metab Res Rev. 2008 May-Jun;24 Suppl 1:S181-7
references.pmid: 18442189
references.citation: J Wound Care. 2010 Jun;19(6):228-33
references.pmid: 20551863
references.citation: BMC Int Health Hum Rights. 2010 May 12;10:7
references.pmid: 20462425
references.citation: J Adv Nurs. 2005 Apr;50(1):47-59
references.pmid: 15788065
references.citation: Int Nurs Rev. 2008 Dec;55(4):434-41
references.pmid: 19146555
references.citation: East Afr Med J. 2003 Jan;80(1):36-43
references.pmid: 12755240
references.citation: Diabetes Res Clin Pract. 2011 Dec;94(3):311-21
references.pmid: 22079683
references.citation: Med Sci Monit. 2005 Aug;11(8):RA262-70
references.pmid: 16049394
references.citation: BMC Int Health Hum Rights. 2011 Sep 26;11:11
references.pmid: 21943099
references.citation: Lancet. 2010 Jun 26;375(9733):2254-66
references.pmid: 20609971
references.citation: Diabetologia. 2009 Jan;52(1):8-16
references.pmid: 18846363
references.citation: Diabet Med. 1997 Sep;14(9):785-91
references.pmid: 9300230
references.citation: Psychol Monogr. 1966;80(1):1-28
references.pmid: 5340840
references.citation: Ann Phys Rehabil Med. 2011 Sep;54(6):359-65
references.pmid: 21840783
references.citation: Psychosom Med. 2003 Sep-Oct;65(5):865-9
references.pmid: 14508033
references.citation: Clin Dermatol. 2007 Jan-Feb;25(1):49-55
references.pmid: 17276201
references.citation: Ostomy Wound Manage. 2004 Feb;50(2):57-67
references.pmid: 15129612
references.citation: Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:116-8
references.pmid: 22271736
references.citation: Health Educ Q. 1988 Summer;15(2):175-83
references.pmid: 3378902
references.citation: Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:225-31
references.pmid: 22271742
references.citation: Lancet. 2005 Nov 12;366(9498):1719-24
references.pmid: 16291066
references.citation: J Adv Nurs. 2002 Dec;40(6):673-84
references.pmid: 12473048
references.citation: J Adv Nurs. 1999 Nov;30(5):1147-59
references.pmid: 10564414