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Level of and factors associated with foot self‐care among people with diabetes in Idlib Province of Northwest Syria: A cross‐sectional study
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Level of and factors associated with foot self‐care among people with diabetes in Idlib Province of Northwest Syria: A cross‐sectional study
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Level of and factors associated with foot self‐care among people with diabetes in Idlib Province of Northwest Syria: A cross‐sectional study
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Journal Article
Level of and factors associated with foot self‐care among people with diabetes in Idlib Province of Northwest Syria: A cross‐sectional study
2024
Overview
Background and aims Diabetic foot and lower limb problems are among the most neglected complications during the Syrian armed conflict due to the absence of a functioning health infrastructure, including early detection and timely management of limb‐threatening wounds. This study aimed to determine self‐reported diabetes‐related foot disease (DRFD), adherence to recommended foot self‐care (FSC) practices, and associated factors among people with diabetes in war‐torn Northwest Syria (NWS). Methods This was a cross‐sectional study conducted at six primary care clinics in Idlib, NWS, between March 27 and April 17, 2022, utilizing the validated interviewer‐administered Diabetes Foot Disease and Foot Care Questionnaire. Data on demographic characteristics, DRFD, and FSC practices were collected. FSC score was determined by adding the points from all 12 FSC items, with a maximum score of 48, and were categorized into very poor (≤12), poor (13–24), moderate (25–36), and good (37–48). A convenience sample of 331 consecutive Syrians, aged ≥18 years, with diabetes, were invited. Multiple linear regression was used to identify variables associated with FSC practices. Results A total of 328 patients completed the questionnaire (response rate: 99.1%). The overall FSC score was average (mean total score 27.24, SD 7.03). Over one‐third (37.8%) had a very poor/poor score, 50.3% had an average score, and 11.9% had a good score. Household income/month of ≥51 USD (β = 2.6, 95% confidence interval [95% CI]:1.06–4.1, p = 0.001) and diabetes duration of ≥10 years (β = 1.8, 95% Cl: 0.2–3.4, p = 0.027) significantly predicted better FSC practice. Conclusion A significant proportion of participants had inadequate adoption FSC behaviors. Higher socioeconomic status was associated with better FSC practices. Future research should evaluate diabetic foot education and professional foot care in this population. Key points The absence of a functioning healthcare service infrastructure in war‐torn NWS made DRFD among the most devastating and neglected complications of diabetes. Overall, the adherence to recommended FSC practices was average. Over a third were in the poor/very poor category. Household income/month of ≥51 USD and diabetes duration of ≥10 years independently predicted improved FSC practices. Enhancing socioeconomic standards may facilitate better adoption of FSC practices.
