Factors influencing foot care behaviour among patients with diabetes: An integrative literature review.
Ming Wei Jeffrey Woo, Jiao Cui
PMID 36973947WHAT IT FOUND
Most diabetic patients neglect foot care.
Education helps, but knowledge alone fails: many know what to do yet do not. Barriers include cost, lack of family support, and fatalistic beliefs. Effective programs address these practical and psychological blocks, not just facts.
Key findings
01Seventeen of the thirty-five included studies observed poor diabetic foot care behaviours among patients, while only seven reported moderate to good behaviours.
02Foot care education is associated with better patient behaviours, but knowledge alone is a poor predictor because many patients know what to do yet do not do it.
03Practical barriers such as cost, lack of insurance, and absence of family support hinder foot self-care, alongside personal beliefs that diabetes does not require foot checks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The review only included English-language peer-reviewed studies from 2011 to 2021, which may have missed relevant research in other languages or time periods. Only three electronic databases were searched, potentially limiting the comprehensiveness of the evidence base. Many of the included studies relied on self-reported data, which is subject to recall bias and social desirability bias. The cross-sectional design of many included studies prevents the establishment of cause-and-effect relationships between factors and foot care behaviours.
Declared interests
No funding was obtained for this review, and the authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the positive association between foot care education and better behaviour as proof that simply handing out leaflets works. Several studies found that patients had good knowledge but poor practice, indicating that education must actively address barriers like cost, self-efficacy, and beliefs about susceptibility to be effective.