Yaşlı Bireylerde Ayak Bakım Davranışlarının Belirleyicileri Olarak Diyabet Yükü ve Öz-Etkililik Düzeyleri: Tanımlayıcı Karşılaştırmalı Çalışma

Abstract

Amaç: Bu çalışmada, diyabetik ayak ülseri olan ve olmayan yaşlı bireylerin ayak bakım davranışlarını, diyabet yükünü ve öz-etkililik düzeylerini belirlemek ve ayak bakım davranışlarını etkileyen belirleyicileri incelemek amaçlamıştır. Gereç ve Yöntemler: Bu tanımlayıcı ve karşılaştırmalı çalışmaya diyabetik ayak ülseri olan 115 ve diyabetik ayak ülseri olmayan 115 yaşlı birey dahil edilmiştir. Verilerin analizinde Mann Whitney U, Kruskal-Wallis, çoklu regresyon analizi kullanılmıştır. Bulgular: Diyabetik ayak ülseri olan yaşlı bireylerde okuryazar olmak (β=0,674), ilde yaşamak (β=0,549), diyabet diyetine uymamak (β=0,408), kronik hastalık sayısının dört olması (β=0,838), insülin kullanmak (β =0,761), kan şekerini ölçmemek (β=0,398), yılda bir ve daha fazla doktora gitmek (β=0,573), son bir yıl içinde şeker hastalığı komplikasyonları nedeniyle hastaneye yatmamak (β =0,789), öz-etkililik toplam puanı (β=0,832) ve alt boyutları, diyabet yükü toplam puanı (β=0,838) ve alt boyutları ayak bakım davranışlarının yordayıcılarıdır (p<0,001). Diyabetik ayak ülseri olmayan yaşlı bireylerde ise okuryazar olmak (β=0,745), diyabet diyetine uymamak (β=0,823), düzenli fiziksel egzersiz yapmamak (β=0,736), öz-etkililik (β=0,801) ve alt boyutları, diyabet yükü düzeyleri (β=0,817) ve alt boyutları ayak bakım davranışlarının yordayıcılarıdır (p<0,001). Sonuç: Diyabetik ayak ülseri olmayan yaşlı bireylerin ayak bakımı davranışları kötüdür. Yaşlı bireylerin diyabet yükü ve öz-etkililik düzeyleri ayak bakım davranışlarını yordamada bir etkiye sahiptir. Bu sonuç doğrultusunda yaşlı bireylerin öz-yeterlik düzeylerinin artırılması hastalık yükünü azaltabilir. Aynı zamanda ayak bakım davranışlarını da olumlu yönde etkileyebilir

Keywords

• Tip 2 diyabet
• Diyabet yükü
• Ayak bakım davranışı
• Yaşlı birey

Diabetes Burden and Self-Efficacy Levels As Determinants of Foot Care Behaviors in Older Adults: Descriptive Comparative Study

Abstract

Aim: This study aimed to determine foot care behaviors, diabetes burden, and self-efficacy levels of older adults with and without diabetic foot ulcer and to examine the determinants affecting their foot care behaviors. Material and Methods: This descriptive comparative study was included 115 older adults with diabetic foot and 115 older adults without diabetic foot. Descriptive statistics, chi-square test, t test, one way anova, mann whitney u, kruskal wallis test and multiple regression analysis were used in the analysis of the data. Results: Being literate (β=0.674), living in a city (β=0.549), not complying with the diabetes diet (β=0.408), having four chronic diseases (β=0.838), using insulin (β =0.761), not measuring blood glucose level (β=0.398), visiting a doctor once a year or more (β=0.573), not being hospitalized due to diabetes complications in the last year (β =0,789), mean scores for the overall Self-Efficacy Scale (β=0.832) and its subdimensions, mean scores for the overall Elderly Burden Diabetes Scale (β=0.838) and its subdimensions (p<0.001). Being literate (β=0.745), not complying with diabetes diet (β=0.823), not doing regular physical exercise (β=0.736), mean scores for the overall Self-Efficacy Scale (β = 0.801) and its subdimensions, mean scores for the overall Elderly Burden Diabetes Scale (β=0.817) and its subdimensions were predictors of foot care behaviors of the older adults without diabetic foot ulcer (p<0.001). Conclusion: Older adults without diabetic foot ulcer displayed poor foot care behaviors. It was determined that the diabetes burden and self-efficacy levels of older adults had a effect on predicting foot care behaviors. In line with this result, increasing the self-efficacy level of older adults may reduce the burden of disease. It may also positively affect foot care behaviors.

Keywords

• Type 2 diabetes
• Diabetes burden
• Foot care behaviour
• Older adults
• Self-efficacy

References

1. 1. Ugwu E, Adeleye O, Gezawa I, Okpe I, Enamino M, Ezeani I. Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria. World J Diabetes. 2019;10(3):200-211.
2. 2. van Netten JJ, Bus SA, Apelqvist J, Lipsky BA, Hinchliffe RJ, Game F, Rayman G, Lazzarini PA, Forsythe RO, Peters EJG, Senneville É, Vas P, Monteiro-Soares M, Schaper NC. Definitions and criteria for diabetic foot disease. Diabetes Metab Res Rev. 2020;36 Suppl 1:e3268.
3. 3. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y.Global epidemiology of diabetic foot ulceration: A systematic review and metaanalysis. Ann Med. 2017;49(2):106-116.
4. 4. Demirseren DD, Emre S, Akoglu G, Arpacı D, Arman A, Metin A, Cakır B. Relationship between skin diseases and extracutaneous complications of diabetes mellitus: Clinical analysis of 750 patients. Am J Clin Dermatol. 2014;15(1):65- 70.
5. 5. Sari Y, Upoyo AS, Isworo A, Taufik A, Sumeru A, Anandari D, Sutrisna E. Foot self-care behavior and its predictors in diabetic patients in Indonesia. BMC Res Notes. 2020;13(1):38.
6. 6. Yıldırım Usta Y, Dikmen Y, Yorgun S, Berdo İ. Predictors of foot care behaviours in patients with diabetes in Turkey. PeerJ. 2019;7:e6416.
7. 7. Ovayolu Ö, Ovayolu N, Doğru A, Özkaya M. The challenge of diabetes in the elderly and affecting factors: A Turkish study. Holist Nurs Pract. 2015;29(5):272-279.
8. 8. Ahmad Sharoni SK, Mohd Razi MN, Abdul Rashid NF, Mahmood YE. Self-efficacy of foot care behaviour of elderly patients with diabetes. Malays Fam Physician. 2017;12(2):2-8.

9. 9. Wendling S, Beadle V. The relationship between selfefficacy and diabetic foot self-care. J Clin Transl Endocrinol. 2015;2(1):37-41.
10. 10. D’Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res. 2017;36:25- 32.
11. 11. Pourkazemi A, Ghanbari A, Khojamli M, Balo H, Hemmati H, Jafaryparvar Z, Motamed B. Diabetic foot care: Knowledge and practice. BMC Endocr Disord. 2020; 20(1):40.
12. 12. Kalaycı Ö, Açıkgöz B, Bayraktaroğlu T, Ayoğlu FN. Evaluation of foot care of diabeted patients and the knowledge, attitude and behavior about diabetic foot. Turk J Diab Obes. 2020;4(2):98- 107.
13. 13. Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression correlation analysis for the behavioral sciences. 2003. 3rd Edition. By Jacop Cahen (Author). Lawrence Erlbaum Associates, Publishers, Mahwah, New Jersey, London. (Chapter II).
14. 14. American Diabetes Assocation (ADA). Standards of medical care in diabetes-2019. Diabetes Care. 2019;42(1):1-204.
15. 15. Embil JM, Albalawi Z, Bowering K, Trepman E. Foot care. Can J Diabetes. 2018;42(Suppl 1): S1-S325.
16. 16. Schaper NC, van Netten JJ, Apelqivist J, Bus SA, Hinchliffe RJ, Lipsky BA. IWGDF Practical guidelines on the prevention and management of diabetic foot disease. 2019. https:// iwgdfguidelines.org/wp-content/uploads/2019/05/IWGDFGuidelines- 2019.pdf
17. 17. American Diabetes Assocation (ADA). Standards of medical care in diabetes-2020. Diabetes Care. 2020;43(1):1-224.
18. 18. Bijl JV, Poelgeest-Eeltink AV, Shortridge-Baggett L. The psychometric properties of the diabetes management selfefficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30(2):352-359.
19. 19. Kara M, van der Bijl JJ, Shortridge-Baggett LM, Asti T, Erguney S. Cross-cultural adaptation of the Diabetes Management Self- Efficacy Scale for patients with type 2 diabetes mellitus: scale development. Int J Nurs Stud. 2006;43(5):611-621.
20. 20. Araki A, Ito H. Development of elderly diabetes burden scale for elderly patients with diabetes mellitus. Geriatr Gerontol Int. 2003;3(4):212-224.
21. 21. Usta YY, Esen A. A study of the validity and reliability of the eldery diabetes burden scale for the Turkish society. Turk Geriatri Derg. 2012;15(1): 61-67.
22. 22. Bodibe TC, Masemola NM, Meyer JC. Diabetic foot care. South African Pharmaceutical Journal. 2019;86(6):17-24.
23. 23. Özdemir Ü, Kurban B, Bayraktaroğlu T. Podologic evaluation of foot in patients with diabetes mellitus. Turk J Diab Obes. 2019;31(1):51-62.
24. 24. Bayraktaroğlu T, Topaloğlu Ö, Tekin S, Eser T, Özdemir Ü, Kurban B, Durmuş A, Öçal K, Uzaldı EB, Çatalçam S, Saruhan S, Çiçekdağ Ö, Gökkaya Z, Özdemir R, Alarçin G. Foot evaluation and preventive practices of diabetic individuals: Zonguldak Bulent Ecevit University Podology Policlinic Example. Turk J Diab Obes. 2022;6(3):274-286.
25. 25. Colak B, Duran R, Can FN, Yormaz S, Zaland AW, Taşdelen E, Sarıhan ND, Arslan M, Öztürk MN, Akbaş AF, Aslan AN, Elagöz O, Lök B, Özşen Y, Ersoy C, Marakoğlu K, Şahin M. Measurement of diabetic patients’ knowledge about diabetic foot wound and evaluation of foot care practices. Turk J Diab Obes. 2020;4(1):22-29.
26. 26. Yücel F, Sunay D. Assessment of knowledge, attitudes and behaviours of diabetic patients about diabetic foot and foot care. Ankara Medical Journal. 2016;16(3):270‐284.
27. 27. Solan YM, Kheir HM, Mahfouz MS, Al-Faify AA, Hakami DT, Al Faifi MA, Hakami AW, Hakami AH, Sharif HH. Diabetic foot care: Knowledge and practice. J Endocrinol Metab. 2016;6(6):172-177.
28. 28. Magbanua E, Lim-Alba R. Knowledge and practice of diabetic foot care in patients with diabetes at Chinese General Hospital and Medical Center. J ASEAN Fed Endocr Soc. 2017;32(2):123- 131.
29. 29. Alhuqayl AA, Alaskar MS, Alsahli FM, Alaqil SA. Awareness of foot care among diabetic patients. IJMDC. 2019;3(2):154- 158.
30. 30. Abate TW, Tareke M, Tirfie M. Self-care practices and associated factors among diabetes patients attending the outpatient department in Bahir Dar, Northwest Ethiopia. BMC Res Notes. 2018;11(1):800.
31. 31. Indrayana S, Guo SE, Lin CL, Fang SY. Illness perception as a predictor of foot care behavior among people with type 2 diabetes mellitus in Indonesia. J Transcult Nurs. 2019;30(1):17- 25.
32. 32. Yılmaz Karadağ F, Saltoğlu N, Ak Ö, Çınar Aydın G, Şenbayrak S, Erol S, Mıstanoğlu Özatağ D, Kadanalı A, Küçükardalı Y, Çomoğlu Ş, Yörük G, Akkoyunlu Y, Meriç Koç M, Altunçekiç Yıldırım A. Foot self-care in diabetes mellitus: Evaluation of patient awareness. Prim Care Diabetes. 2019;13(6):515-20.
33. 33. Ayele BH, Mengesha MM, Tesfa T. Predictors of self-care activities of outpatient diabetic residents in Harar and Dire Dawa: A hospital-based cross-sectional study. SAGE Open Med. 2019;7: 2050312119865646.
34. 34. Mariye T, Tasew H, Teklay G, Gerensea H, Daba W. Magnitude of diabetes self-care practice and associated factors among type two adult diabetic patients following at public Hospitals in central zone, Tigray Region, Ethiopia, 2017. BMC Res Notes. 2018;11(1):380.
35. 35. Alarçin G, Ünver B, Eser T, Bayraktaroğlu T. The effect of glycemic control level on functional mobility and foot function in type 2 diabetic individuals. Turk J Diab Obes. 2019;3(2):85- 91.
36. 36. Nguyen TPL, Edwards H, Do TND, Finlayson K. Effectiveness of a theory-based foot care education program (3STEPFUN) in improving foot self-care behaviours and foot risk factors for ulceration in people with type 2 diabetes. Diabetes Res Clin Pract. 2019;152:29-38.
37. 37. Rahaman HS, Jyotsna VP, Sreenivas V, Krishnan A, Tandon N. Effectiveness of a patient education module on diabetic foot care in outpatient setting: An open-label randomized controlled study. Indian J Endocrinol Metab. 2018;22(1):74-78.
38. 38. Tel Aydın H, Çelik P. The Effect of preventive patient educational program about diabetic foot development on patients’ knowledge and practice of foot care. Turk J Diab Obes. 2020;4(2):90-97.
39. 39. Ahmad Sharoni SK, Abdul Rahman H, Minhat HS, Shariff- Ghazali S, Azman Ong MH. The effects of self-efficacy enhancing program on foot self-care behaviour of older adults with diabetes: A randomised controlled trial in elderly care facility, Peninsular Malaysia. PLoS One. 2018;13(3);e0192417.
40. 40. Huda N, Sukartini T, Pratiwi NW. The impact of self efficacy on the foot care behavior of type 2 diabetes mellitus patients in Indonesia. Jurnal Ners. 2019;14(2):181-186.
41. 41. Kaya UP, Ozden Dedeli C. Association between social support and diabetes burden among elderly patients with diabetes: A cross-sectional study from Turkey. Saudi J Med Med Sci. 2019;7(2):86-92.