title: Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: a prospective study.
abstract: OBJECTIVE
  Patients' illness beliefs are known to be influential determinants of self-care behaviours in many chronic conditions. In a prospective observational study we examined their role in predicting foot self-care behaviours in patients with diabetic foot ulcers.
  
  
  METHODS
  Patients (n=169) were recruited from outpatient podiatry clinics. Clinical and demographic factors, illness beliefs and foot self-care behaviours were assessed as baseline (week 0). Foot self-care behaviours were assessed again 6, 12 and 24 weeks later. Linear regressions examined the contribution of beliefs at baseline to subsequent foot self-care behaviours, controlling for past behaviour (i.e., foot self-care at baseline) and clinical and demographic factors that may affect foot self-care (i.e., age and ulcer size).
  
  
  RESULTS
  Our models accounted for between 42 and 58% of the variance in foot self-care behaviours. Even after controlling for past foot-care behaviours, age and ulcer size; patients' beliefs regarding the symptoms associated with ulceration, their understanding of ulceration and their perceived personal control over ulceration emerged as independent determinants of foot self-care.
  
  
  CONCLUSIONS
  Patients' beliefs are important determinants of foot-care practices. They may, therefore, also be influential in determining ulcer outcomes. Interventions aimed at modifying illness beliefs may offer a means for promoting self-care and improving ulcer outcomes.
authors.affiliation: Division of Primary Care, School of Medicine, University of Nottingham, NG7 2RD, UK. Electronic address: kavita.vedhara@nottingham.ac.uk.
authors.forename: Kavita
authors.initials: K
authors.lastname: Vedhara
authors.affiliation: School of Social and Community Medicine, University of Bristol, BS8 2PS, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Dawe
authors.affiliation: Department of Psychology, University of Northumbria, NE1 8ST, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Wetherell
authors.affiliation: Rand Institute, Los Angeles, CA 90401, USA.
authors.forename: Jeremy N V
authors.initials: JN
authors.lastname: Miles
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, M13 9PL, UK.
authors.forename: Nicky
authors.initials: N
authors.lastname: Cullum
authors.affiliation: Institute of Molecular and Experimental Medicine, University of Cardiff, CF14 4XN, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Dayan
authors.affiliation: Department of Podiatry, Southmead Hospital, BS10 5NB, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Drake
authors.affiliation: School of Healthcare Studies, Cardiff University, CF14 4XN, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
authors.affiliation: Matrix Biology Research Group, University of Bristol, BS40 5DU, UK.
authors.forename: John
authors.initials: J
authors.lastname: Tarlton
authors.affiliation: Health Psychology Section, Institute of Psychiatry, SE1 9RT, UK.
authors.forename: John
authors.initials: J
authors.lastname: Weinman
authors.affiliation: Department of Cellular and Molecular Medicine, University of Bristol, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Day
authors.affiliation: School of Social and Community Medicine, University of Bristol, BS8 2PS, UK.
authors.forename: Rona
authors.initials: R
authors.lastname: Campbell
mesh_terms: D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D017719:Diabetic Foot / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology*
keywords: Diabetic foot ulcers; Illness beliefs; Self-care behaviours; Self-management