Mahuya Karmakar, Debdutta Mandal-IJSRE Volume 06 Issue 01 January 2018 Page 7782 Volume||6||Issue||01||January-2018||Pages-7782-7787||ISSN(e):2321-7545 Website: http://jsae.in
Index Copernicus Value- 76.10 DOI: http://dx.doi.org/10.18535/ijsre/v6i1.02
Knowledge and practice of foot self-care among the patients with diabetes mellitus in
selected hospitals of Kolkata, West Bengal.
Authors
Mahuya Karmakar1, Debdutta Mandal2
1
DNS cum Principal, Institute of Neurosciences-Kolkata;
2
Assistant Professor, Asia Heart College of Nursing, Kolkata ABSTRACT-
A descriptive study to assess the foot self care knowledge & practice among the patient with diabetes mellitus in a selected hospital of Kolkata, was conducted with the aim to identify the foot self care knowledge deficit & health belief regarding foot self care, to assess the level of knowledge on foot self care among patients with diabetes mellitus, to find out association between knowledge level of foot self care among patients with diabetes mellitus with selected demographic variables & to find out association between practice of foot self care, to find co-relation between knowledge & practice of foot self care among the patients with diabetes mellitus, 150 patients were selected from OPD of selected hospital Kolkata by using non probability convenient sampling technique. A semi structured questionnaire comprising of demographic variables & checklist for assessing knowledge of foot self care & structured questionnaire for assessing practice of foot self care among patients with diabetes mellitus was used for data collection. The finding of the study revealed that, 86.67% had good knowledge where as in the practice 42.67% had satisfactory practice. Significant association (p>0.05) was found between treatment of diabetes mellitus and knowledge score of foot-self care and also association (p>0.05) was found between educational status, family history of diabetes mellitus and practice of foot-self care among the patients with diabetes mellitus. In Karl Pearson’s Correlation Coefficient method, moderately positive Correlation(r= 0.2) was found between knowledge & practice regarding foot-self care among the patients with diabetes mellitus.
Keywords- foot self-care, diabetes mellitus, knowledge and practice
INTRODUCTION-
Mahuya Karmakar, Debdutta Mandal-IJSRE Volume 06 Issue 1 January 2018 Page 7783 with diabetes mellitus. This should be the goal of every one providing care for the patients with diabetes mellitus.(9)
MATERIALS AND METHODS-
A descriptive study was conducted between February 2017 and March 2017. The study protocol was approved by Institutional ethical committee of Woodlands Multispeciality Hospital limited. Written informed consent was obtained from each respondent.
Operational Definition:
Patients with diabetes mellitus:- In this study, patients with diabetes mellitus are all the patients diagnosed by physicians for diabetes mellitus admitted in selected hospital.
Foot Self-care Knowledge: -In this study, foot self-care knowledge is the information of foot self-care which should be known by the patients of diabetes mellitus according to structured questionnaires.
Foot self-care practice: - Self-care is defined by Orem as the practice of activities for the maintenance of life, health and well-being, carried out by the individual for his/her own benefit. Foot self-care should include washing, drying and lubricating foot. In this study, foot self-care behavior is the steps followed by patients for foot self-care practices according to the checklist.
Selected demographic factors: -In this study, selected demographic variables are age, sex, heredity, qualification, socio economic status of the patient of selected hospital of Kolkata, West Bengal.
Conceptual Framework
The Conceptual Framework of the study was based on Orem’s (1995) self –care theory- Theory has different strong concepts which are associated with successful self-care. These are:-
Self-care: Practices of activities that individual initiates & perform on their own behalf in maintaining life, health and well-being.
Here the study is conducted for assessment of foot self-care practice.e.g. Dietary precaution, physical activities and foot care.
Self-care agency: It is a human ability which is “The ability for engaging in self-care”-condition by age development state, life experience, socio-cultural orientation health and available resources.
In the present study self-care agency are –demographic factor, health state, family system factor, and living pattern.
Therapeutic self-care demand: “Totality of self-care actions to be performed for some duration in order to meet self-care requisites by using valid methods and related sets of operations and actions.”
In this study, therapeutic self-care demand are- medication, skin care, complementary mechanism for protection and maintenance of function when sensory deficit is present.
Self-care requisite: Action directed towards provision of self-care.3 categories of self-care requisite are – Universal self-care requisite
Developmental self care requisite Health deviation self care requisites.
Mahuya Karmakar, Debdutta Mandal-IJSRE Volume 06 Issue 1 January 2018 Page 7784 Schematic Diagram of Orem’s Self-care Theory
OBJECTIVES OF THE STUDY:
The result was computed using descriptive & inferential statistics based on the objectives of the study, as follows-
To assess the level of knowledge on foot self-care among the patients with diabetes mellitus as measured by checklist.
To assess the foot self care practice among the patient with diabetes mellitus as measured by structure questionnaires.
To find out association between knowledge of foot self-care among the patients with diabetes mellitus with selected demographic factors.
To find corelation between knowledge & practice of foot self care among the patients with diabetes mellitus.
SAMPLING STRATEGY AND DATA COLLECTION TOOLS AND TECHNIQUES:
Sampling technique: 150 patients with diabetes mellitus who were 40 & more than 40 yrs of age of the selected hospital of Kolkata, West Bengal were chosen as the sample by convenience sampling technique. Inclusion criteria:
Diabetic patients more than 40yrs of age who are attending OPD of selected hospitals. Patients attending OPD of selected hospital who have diabetes mellitus for more than 5yrs. Patients who are able to understand Bengali& English.
Patients who are willing to participate in the study. Data collection tools & techniques:
The most important aspect of any investigation is the data collection of appropriate information which provides necessary data to answers questions raised in the study. The following are presented in the following table:
Orem’s Self-care
Model
Self-care: -Dietary Precautions-Physical Activities -Foot care
Self-care Requisite: -Not included in this
study
Therapeutic Self- care demand : -Medication
-Skin care -Complementary mechanism for protection &
maintenance of function when sensory deficit is
present
Self-care Agency: -Age -Health state -Socio-cultural orientation
Mahuya Karmakar, Debdutta Mandal-IJSRE Volume 06 Issue 1 January 2018 Page 7785 Data collection tools and techniques:
Data collection instruments were constructed in order to collect necessary information like 14 semi structured questionnaire on demographic profile, 12 item standardized checklist on diabetic foot self –care Knowledge with maximum score is 12, and Structured questionnaire on diabetic foot self-care practice with multiple choice questionnaires of total items of 29 with the maximum score of 87 were used.
Content validity of the tool was obtained by submitting the tools (semi-structured questionnaires, structured knowledge & practice questionnaire & blue print of the content) to 5 experts to obtain their opinion & suggestion.
Try out:-
Try out was conducted to check the reality of items & ambiguity of the language of the tool. Formal administrative permission was obtained from the hospital authority.
RESULT AND DATA ANALYSIS-
Data was analysed by using descriptive and inferential statistics. Findings of the study-
Out of 150 respondents, majority (41.33%) were within the age group of 51-60 yrs, 55.33% were female and were at secondary education, 50.67% had no family history of DM, 51.33% had DM for 10-15 yrs, 71.33% used to take oral tablets for DM, 52.67% were taking treatment for 10-15 yrs for DM and 90.67% got information regarding DM from professional.
Study result showed 6.49*as significant association between types of treatment & knowledge of foot self care. There was statistical significant association found between educational status & practice of foot self care. There was statistical significant association found between family history (9.47*) & practice of foot self care (4.04*). A moderately positive Correlation between knowledge & practice regarding foot-self care among the patients with diabetes mellitus were also found.
DISCUSSION:
Very few studies had been found supporting the researcher’s results. Among the few Krishna Institution of Nursing Sciences had conducted a study on 50 samples to assess the knowledge & practice regarding the foot care among the patients with diabetes mellitus. Maximum 20 (40%) of the diabetic patients belonged to the age group of 51-60 yrs& minimum 12(24%) belonged to 41-50yrs. Among the diabetic patients 26 (52%) were males 24(48%) were females. Majority of the patients education was 13(26%) belonged non-formal education. Maximum number of patients 33(66%) had duration of diabetes mellitus<5yrs. The level of knowledge score of diabetes mellitus patients regarding foot self care revealed that 12(24%) had good knowledge & 9(18%) had poor knowledge. The level of practice score of diabetic patients regarding foot care revealed that 11(22%) had good practice & 10(20%) had poor practice.
Chi-square test used to test the association of knowledge & practice regarding foot care among diabetic patients with demographic variables & it was found that there was an association between knowledge regarding foot care among diabetic patients with marital status, associated illness & types of diabetes. Besides marital status, occupational status & residential areas were associated with practice regarding foot care among the diabetic patients.
Mahuya Karmakar, Debdutta Mandal-IJSRE Volume 06 Issue 1 January 2018 Page 7786 In chi-square test, there was association between knowledge regarding foot self-care among diabetic patients with duration of treatment .Educational status and family history were associated with practice regarding foot self-care among diabetic patients.
The co-relation between knowledge and practice regarding foot self- care was studied by Karl Pearson’s Correlation Coefficient Method. The result was 0.2 i.e. moderately positive correlation.
CONCLUSION:
The present study shows knowledge and practice in self foot care in diabetic patients both are gradually increase due to their long course of disease. It evidenced that this knowledge is not always translated into self-care actions for diabetic foot prevention. There is significant association between patients’ educational status regarding diabetes mellitus and practice of foot-self care among the patients with diabetes mellitus. . Educational programs focusing on awareness of diabetic foot care must directly involve the community, and thereupon in order to reduce the incidence of diabetic foot complications. This should be done in primary care up to tertiary care centers as a multidisciplinary effort.
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