Frontiers in endocrinology · 2026
Factors associated with foot self care behavior among older adults with recurrent diabetic foot ulcer: a cross-sectional study.
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Lin Liping, He Jianbing, Zhang Hongjian, Yang Aiwen, Cai Qiuni
Аннотация
BACKGROUND: Diabetic foot ulcers (DFU) are a severe complication of diabetes, with high recurrence rates and substantial clinical burden. Foot self-care behavior is essential for preventing ulcer recurrence, yet evidence specifically targeting older adults with recurrent DFU remains limited. This study aims to identify the factors associated with foot self-care behavior among older adults with recurrent diabetic foot ulcers.
METHODS: A cross-sectional study was conducted using a purposive sampling technique among 170 older adults (≥60 years) with recurrent DFU recruited from the multidisciplinary diabetic foot clinics of three general hospitals in China between January 2023 and December 2024. The study adhered to the STROBE guidelines for cross-sectional studies. Data were collected using structured questionnaires, including the Nottingham Foot Care Assessment (NAFF), Foot Care Confidence Scale, Multidimensional Scale of Perceived Social Support, and Geriatric Depression Scale (GDS-15). Clinical characteristics were extracted from medical records. Multiple linear regression analysis was performed to identify factors associated with foot self-care behavior.
RESULTS: The mean total NAFF score was 48.5 ± 10.2, indicating a moderate level of foot self-care. Foot care self-efficacy (β = 0.41, P < 0.001), receipt of foot care health education (β = 0.25, P = 0.001), perceived social support (β = 0.19, P = 0.008), and depressive symptoms (β = -0.17, P = 0.021) were factors associated with foot self-care behavior, collectively explaining 47.2% of the variance in foot self-care behavior (adjusted R² = 0.472).
CONCLUSION: Foot self-care behavior among older adults with recurrent DFU is moderate and is associated with modifiable psychosocial factors. Interventions targeting self-efficacy, health education, social support, and depressive symptoms may contribute to improved self-care and potentially reduce ulcer recurrence. Longitudinal and interventional studies are warranted to confirm these associations and evaluate clinical effectiveness.
METHODS: A cross-sectional study was conducted using a purposive sampling technique among 170 older adults (≥60 years) with recurrent DFU recruited from the multidisciplinary diabetic foot clinics of three general hospitals in China between January 2023 and December 2024. The study adhered to the STROBE guidelines for cross-sectional studies. Data were collected using structured questionnaires, including the Nottingham Foot Care Assessment (NAFF), Foot Care Confidence Scale, Multidimensional Scale of Perceived Social Support, and Geriatric Depression Scale (GDS-15). Clinical characteristics were extracted from medical records. Multiple linear regression analysis was performed to identify factors associated with foot self-care behavior.
RESULTS: The mean total NAFF score was 48.5 ± 10.2, indicating a moderate level of foot self-care. Foot care self-efficacy (β = 0.41, P < 0.001), receipt of foot care health education (β = 0.25, P = 0.001), perceived social support (β = 0.19, P = 0.008), and depressive symptoms (β = -0.17, P = 0.021) were factors associated with foot self-care behavior, collectively explaining 47.2% of the variance in foot self-care behavior (adjusted R² = 0.472).
CONCLUSION: Foot self-care behavior among older adults with recurrent DFU is moderate and is associated with modifiable psychosocial factors. Interventions targeting self-efficacy, health education, social support, and depressive symptoms may contribute to improved self-care and potentially reduce ulcer recurrence. Longitudinal and interventional studies are warranted to confirm these associations and evaluate clinical effectiveness.