Awareness and practices of foot self-care in patients with diabetes at Dr Yusuf Dadoo district hospital, Johannesburg

Objectives: To determine awareness and foot self-care practices in patients with diabetes. Design: A cross-sectional descriptive study. Setting and subjects: This study was conducted on 120 consecutive patients with diabetes at the outpatient department of Dr Yusuf Dadoo district hospital, Krugersdorp, Johannesburg. A researcher-administered questionnaire, adapted from the Summary of Diabetic Self-Care Activities, collected information on participants' demographics, clinical co-morbidities, awareness and foot self-care practices. The researcher also conducted a foot examination to identify foot pathologies. Data analysis included descriptive statistics, chi-square and t-tests, and logistic regression. Outcome measures: Patients' awareness of, and practices pertaining to, foot self-care. Results: Of the 120 participants, the majority were blacks (59.2%), female (60%) and unemployed (68.3%). The mean age was 56.3 years. Athlete's foot was the most common foot problem that occurred in 16.2% of participants. While only 24.2% reported awareness of foot self-care, 71.7% had performed foot self-care sometimes in the past, and 69.2% had done so at least one day within the last week. Only 5.8% of participants had had their feet examined by a podiatrist, and 32.5% by a doctor or nurse. Approximately 46.7% regularly soaked their feet in water, 7.5% applied talcum powder to dry their feet, 54.2% inspected their shoes and 25% walked barefoot. Smoking was the only variable that was significantly associated with finding a foot ulcer. Conclusion: Poor participants' awareness and foot self-care practices highlight critical gaps in the care provided to patients with diabetes. Interventions which empower patients and healthcare professionals to regularly perform foot examinations and foot self-care are required to improve diabetic foot care in South Africa.