Exploring Determinants of Foot Self-Care Behaviors Across Adherence Levels in Patients With Diabetic Foot Ulcer History: A Quantile Regression Approach.

This was a cross-sectional survey, so it shows associations at one time point and cannot show that any factor caused better or worse foot self-care. Participants were recruited by convenience from one tertiary hospital outpatient clinic, and all had a history of diabetic foot ulcers and were not in acute treatment, so results may not apply to patients with acute ulcers, amputations, different settings or other ulcer causes. Foot self-care behavior was self-reported, so recall or social desirability may have made adherence look higher than it was. The foot self-care behavior scale had Cronbach's alpha of 0.67 in this study, which is lower than the conventional threshold. Anxiety and depression were highly correlated, with a correlation of 0.85, which made their separate regression effects difficult to interpret. The sample size was 130, and estimates at the 10th and 90th percentiles should be read cautiously because fewer observations fall at the extremes.

The authors declared no conflicts of interest.

Do not conclude that raising foot care knowledge, reducing stigma, treating depression or increasing social support will improve foot self-care or prevent diabetic foot ulcers. This was a cross-sectional survey of associations in a convenience sample, not an intervention study.