BibTex RIS Kaynak Göster

Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care

Yıl 2016, Cilt: 16 Sayı: 3, 270 - 284, 23.09.2016
https://doi.org/10.17098/amj.53438

Öz

Objectives: To assess the knowledge, attitudes and behaviors of diabetic patients and related factors about diabetic foot (DF) and foot care.

Materials and Methods: Patients attended to family medicine out-patient clinics of Keçiören Training and Research Hospital for follow-up and treatment of diabetes (DM) between May-August 2014 were included in this cross-sectional study. Study data were collected by a questionnaire consisting of 56 items that questioned socio-demographic characteristics, knowledge, attitudes and behaviors of patients about diabetic foot (DF) and foot care. Correct answers to the questions were considered ‘1’ point and wrong ones were ‘0’ point. Collected scores were converted to hundred standard scores after the raw scores were calculated. The height, body weight, blood pressure measurements and foot examination of all patients were fulfilled, urea, creatinine, fasting and postprandial blood glucose levels were assessed. Besides the frequencies and percentage distributions, correlation and chi square analysis were used for the evaluation of associations between variables, Mann-Whitney U and Kruskall-Wallis H tests were used for the comparisons of groups.

Results: Seventy-nine percentage (n:139) of 176 patients included into the study were women and 21.0% (n:37) were men. Mean age was 58.0±10.6 years. 54.6% (n:96) of the patients had hypertension. There was foot ulcer in 9.7% (n:17), hospitalization for foot ulcer in 3.4% (n:6), operation history in 2.8% (n:5) of the patients. The 45.5% (n:80) of the patients noted that they do regular foot care, 79% (n:139) check their soles regularly, %25.6 (n:45) check inside of shoes before dressed, while 54% (n:95) noted that they walk barefoot in and outside of home.  According to physical examination findings, 50% (n:88) of the patients were found in high risk group for DF. Sixty-five % (n:114) of the participants had not received any education about DM and 90.9% (n:160) about DF and foot care. The 93.8% of the patients who were doing regular foot care and 82.3% of who were not doing stated that diabetic patients should do regular foot care.  The average knowledge score of the patients was 70.6±21.1, attitude and behavior score was 48.1±13.3out of 100. There was a positive correlation between knowledge scores and attitude and behavior scores (p=0.02). Gender, education, education about DM and type of treatment had no effects on knowledge, attitudes and behaviors. Whereas, DM diagnosis time, control frequency and risk status for DF had no effect on knowledge scores; attitude and behavior scores were high in patients who were followed up to 10-20 years, controlled regularly and who had high risk for DF (p=0.007, p=0.04 and p=0.02, respectively). The knowledge, attitude and behavior scores of patients who had another DM patient in the family were higher than the patients without (p=0.003 and p=0.004, respectively).     

Conclusion: It was observed that diabetic patients did not receive education about DF and foot care, and also did not practice even if their knowledge was enough. Standardized education about DM and DF should be given to all diabetic patients regularly and implementation of the points should be emphasized in educations be followed up closely. 

Kaynakça

  • Levin ME. Foot lesions in patients with diabetes mellitus. End Met Clin North Am 1996;25:447-62.
  • DeFronzo RA, Reasner C. Implications for the diabetic foot. J Foot Ankle Surg 1994;33:551-6.
  • Demir Y, Demir S, Gökçe Ç. Diyabetik Ayak :Fizyopatolojisi, Tanısı ve Rekonstrüksiyon Öncesi Tedavisinde Güncel Yaklaşımlar. The Medical Journal of Kocatepe 2004;5:1-12.
  • Gibbons G.W. The Diabetic Foot. In: Principles and Practice of Endocrinology and Metabolis, Becker KL (eds). 3rd ed. Baltimore: Lippincott Williams & Wilkins; 2001:78-82.
  • BresaterLE, Welin L, Romanus B. Foot pathology and risk factors for diabetic foot disease in elderly men. Diabetes Res Clin Pract 1996;32:103-9.
  • TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. Ankara: Pelin Ofset Matbaacılık Ltd. Şti.; 2015:149-56.
  • Nicolucci A, Cavaliere D, Scorpiglione N, et al. A comprehensive assesment of avoidability of long-term complications of diabetes. A case-control study. Italian Study Group for the implementation of the St.Vincent Declaration. Diabetes Care 1996;19(9):927-33.
  • George H, Rakesh PS, Krishna M, Alex R, Abraham VJ, George K, Prasad JH. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in Southern India. J Family Med Prim Care 2013;2(1):27-32.
  • Desalu OO, Salawu FK, Jimoh AK. Diabetıc foot care: self reported knowledge and practıce among patıents attendıng three tertıary hospıtal ın Nigeria. Ghana Med J 2011;45(2):60-5.
  • Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc 2009;59(10):687-90.
  • Aypak C, Koç A, Yıkılkan H, Görpelioğlu S. Diyabetik ayak bakımı: aile hekimliği polikliniğine başvuran hastalar tarafından bildirilen uygulama durumu. Cumhuriyet Tıp Dergisi 2012;34:423-8.
  • Abu-Qamar MZ. Knowledge and practice of foot self-care among Jordanians with diabetes: an interview-based survey study. J Wound Care 2014;23(5):247-50.
  • Lamchahab FZ, El Kihal N, Khoudri I, Chraibi A, Hassam B, Ait Ourhroui M. Factors influencing the awareness of diabetic foot risks. Ann Phys Rehabil Med 2011;54(6):359-65.
  • Batkın D, Çetinkaya F. Diyabetes mellitus hastalarının ayak bakımı ve diyabetik ayak hakkındaki bilgi, tutum ve davranışları. Journal of Health Sciences 2005;14(1):6-12.
  • Valk GD, Kriegsman DM, Assendelft WJ. Prognostic factors in treatment of diabetic foot ulceration. A systematic review. Endocrinol Metab Clin North Am 2002;31 (3):633-55.
  • Vatankhah N, Khamseh ME, Noudeh YJ, Aghili R, Baradaran HR, Haeri NS. The effectiveness of foot care education on people with type 2 diabetes in Tehran, Iran. Prim Care Diabetes 2009;3(2):73-7.
  • Schmidt S, Mayer H, Panfil EM. Diabetes foot self-care practices in the German population. J Clin Nurs 2008;17(21):2920-6.
  • Donohoe ME, Fletton JA, Hook A, Powell R, Robinson I, Stead JW, Sweeney K, Taylor R, Tooke JE. Improving foot care for people with diabetes mellitus--a randomized controlled trial of an integrated care approach. Diabet Med 2000;17(8):581-7.
  • De Berardis G, Pellegrini F, Franciosi M et al. Are type 2 diabetic patients offered adequate foot care? The role of physician and patient characteristics. J Diabetes Complications 2005;19(6): 319-27.
  • Dorresteijn JA, Kriegsman DM, Assendelft WJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev 2014;16:12.
  • Gale L, Vedhara K, Searle A, Kemple T, Campbell R. Patients’ perspectives on foot complications in type 2 diabetes: a qualitative study. Br J Gen Pract 2008;58:555-63.
  • Mason J, O’Keeffe C, McIntosh Mason J, O'Keeffe C, McIntosh A, Hutchinson A, Booth A, Young RJ. A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. I: prevention. Diabet Med 1999;16(10):801-12.
  • Valk GD, Kriegsman DM, AssendelftWJ. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev 2001;4:CD001488.
  • Viswanathan V, Shobhana R, Snehalatha C, Seena R, Ramachandran A.Need for education on footcare in diabetic patients in India. J Assoc Physicians India 1999;47(11):1083-5.
  • Pollock RD, Unwin NC, Connolly V. Knowledge and practice of foot care in people with diabetes. Diabetes Res Clin Pract 2004;64(2):117-22.
  • Khamseh ME, Vatankhah N, Baradaran HR. Knowledge and practice of foot care in Iranian people with type 2 diabetes. Int Wound J 2007;4(4):298-302.
  • Saleh F, Mumu SJ, Ara F, Begum HA, Ali L. Knowledge and self-care practices regarding diabetes among newly diagnosed type 2 diabetics in Bangladesh: a cross-sectional study. BMC Public Health 2012;12:1112.
  • Sriussadaporn S, Ploybutr S, Nitiyanant W, Vannasaeng S, Vichayanrat A. Behavior in self-care of the foot and foot ulcers in Thai non-insulin dependent diabetes mellitus. J Med Assoc Thai 1998;81(1):29-36.
  • Neil JA. Assessing foot care knowledge in a rural population with diabetes. Ostomy Wound Manage 2002;48(1):50-6.
  • Moreno Hernondez Mİ, Trilla Soler M, Esplerga Capdevilla A et al. Self-care and risk factors of diabetic foot in patients with type II diabetes mellitus. Aten Primaria 1997;20(4):185-90.
  • Lasker RD. The diabetic control and complications trial. Implications for policy and practice. N Eng J Med 1993;329(14):1035-6.
  • Özer E, Şengül AM, Gedik S, Salman S, Salman F, Sargın M, İşsever H, Yılmaz T. Diabetes Education:a chance to improve well being of Turkish people with type II diabetes. Patient Educ Couns 2003;51(1):39-44.
  • Ersoy C, Tuncel E, Özdemir B, Ertürk E, İmamoğlu Ş; İnsülin Kullanan Tip 2 DM’lu Hastalarda Diyabet Eğitimi ve Metabolik Kontrol, 2006. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006;32(2): 43-7.
  • Boyko E J, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ. Predictable of Diabetic Foot Ulcer Occurence Using Commonly Available Clinical Information: The Seattle Diabetic Foot Study. Diabetes Care 2009;29(6):1202-7.
  • Carrington AL, Abbot CA, Griffiths J, Jackson N, Johnson SR, Kulkarni J, Van Ross ER, Boulton AJ. A foot care program for diabetic unilateral lower-limb amputees. Diabetes Care 2001;24: 216-21.

Diyabetik Hastaların Diyabetik Ayak ve Ayak Bakımıyla İlgili Bilgi, Tutum ve Davranışlarının Değerlendirilmesi

Yıl 2016, Cilt: 16 Sayı: 3, 270 - 284, 23.09.2016
https://doi.org/10.17098/amj.53438

Öz

Amaç: Diyabetli (DM) hastaların diyabetik ayak (DA) ve ayak bakımı ile ilgili bilgi, tutum ve davranışlarını ve ilişkili faktörleri değerlendirmek.

Materyal ve Metot: Kesitsel tipteki çalışmaya Mayıs-Ağustos 2014 tarihleri arasında, DM tanısıyla takip ve tedavi için Keçiören Eğitim ve Araştırma Hastanesi Aile Hekimliği Poliklinikleri’ne başvuran hastalar dahil edildi. Çalışma verileri, araştırmacı tarafından hazırlanan ve hastaların sosyo-demografik özellikleri, DA’la ilgili bilgi, tutum ve davranış düzeyini sorgulayan 56 sorudan oluşan anket formu ile toplandı. Sorulara verilen doğru cevaplar ‘1’, yanlış cevaplar ‘0’ puan olarak değerlendirildi. Ham puanlar hesaplandıktan sonra elde edilen puanlar yüzlük standart puana çevrildi. Tüm hastalara boy, vücut ağırlığı, kan basıncı ölçümleri ve ayak muayenesi yapıldı, üre, kreatinin, açlık tokluk kan glukozu düzeyleri değerlendirildi. Elde edilen verilerin değerlendirilmesinde frekans ve yüzdesel dağılımların yanında, değişkenler arasındaki ilişki korelasyon analizi ve Ki-Kare analizi, gruplar arasında değerlerin karşılaştırılmasında Mann-Whitney U ve Kruskall-Wallis H testi kullanıldı.

Bulgular: Çalışmaya dahil edilen 176 hastanın %78,98’i (n=139) kadın %21,02’i (n=37) erkekti. Yaş ortalaması 57,96±10,60 yıldı. Hastaların %54,55’inde (n:96) hipertansiyon mevcuttu. Yüzde %9,70’inde (n:17) ayak yarası, %3,40’ında (n:6) ayak yarası nedeniyle hastanede yatış, %2,80’inde (n:5) operasyon öyküsü vardı. Yüzde 45,50’si (n:80) düzenli ayak bakımı yaptığını, %79,00’u (n:139) ayak tabanlarını düzenli kontrol ettiğini, %25,60’ı (n:45) giyinmeden önce ayakkabısının içini kontrol ettiğini belirtirken %54,00’ü (n:95)  evde ya da dışarıda yalınayak yürüdüğünü belirtti. Muayene bulgularına göre %50,00 (n:88) hastanın DA için yüksek risk grubunda yer aldığı saptandı. Katılımcıların % 64,80’i (n:114) DM ilişkin, %90,90’ı (n:160) da DA ve ayak bakımıyla ilgili herhangi bir eğitim almamıştı. Düzenli ayak bakımı yapanların %93,80’i, yapmayanların %82,30’u DM’li hastaların düzenli ayak bakımı yapması gerektiğini belirtti. Hastaların ortalama bilgi düzeyi puanı 100 üzerinden 70,58±21,12; tutum ve davranış puanı 48,13±13,28 idi. Bilgi düzeyi ile tutum ve davranış puanı arasında pozitif korelasyon saptandı (p=0,02). Cinsiyet, eğitim, DM ilişkin eğitim alma durumu ve tedavi şeklinin bilgi, tutum ve davranış üzerine etkisi saptanmadı. DM tanı süresi, kontrol sıklığı ve DA için risk durumunun bilgi düzeyine etkisi yokken tutum ve davranış puanlarının 10-20 yıldır takip edilenlerde, düzenli kontrole gidenlerde ve DA için yüksek risk taşıyanlarda daha yüksek olduğu saptandı (sırasıyla p=0,007, p=0,04 ve p=0,02). Ailesinde başka DM’li hasta olanların bilgi, tutum ve davranış puanları olmayanlara göre daha yüksekti (sırasıyla p=0,003 ve p=0,004).     

Sonuç: Diyabetik hastaların DA ve ayak bakımı ile ilgili eğitim almadıkları, bilgileri yeterli olsa dahi bildiklerini uygulamadıkları görülmektedir. Standardize edilmiş DM ve diyabetik ayak eğitimi tüm hastalara düzenli aralıklarla verilmeli ve eğitimde vurgulanan noktaların uygulanma durumu yakından takip edilmelidir.

Kaynakça

  • Levin ME. Foot lesions in patients with diabetes mellitus. End Met Clin North Am 1996;25:447-62.
  • DeFronzo RA, Reasner C. Implications for the diabetic foot. J Foot Ankle Surg 1994;33:551-6.
  • Demir Y, Demir S, Gökçe Ç. Diyabetik Ayak :Fizyopatolojisi, Tanısı ve Rekonstrüksiyon Öncesi Tedavisinde Güncel Yaklaşımlar. The Medical Journal of Kocatepe 2004;5:1-12.
  • Gibbons G.W. The Diabetic Foot. In: Principles and Practice of Endocrinology and Metabolis, Becker KL (eds). 3rd ed. Baltimore: Lippincott Williams & Wilkins; 2001:78-82.
  • BresaterLE, Welin L, Romanus B. Foot pathology and risk factors for diabetic foot disease in elderly men. Diabetes Res Clin Pract 1996;32:103-9.
  • TEMD Diabetes Mellitus Çalışma ve Eğitim Grubu. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. Ankara: Pelin Ofset Matbaacılık Ltd. Şti.; 2015:149-56.
  • Nicolucci A, Cavaliere D, Scorpiglione N, et al. A comprehensive assesment of avoidability of long-term complications of diabetes. A case-control study. Italian Study Group for the implementation of the St.Vincent Declaration. Diabetes Care 1996;19(9):927-33.
  • George H, Rakesh PS, Krishna M, Alex R, Abraham VJ, George K, Prasad JH. Foot care knowledge and practices and the prevalence of peripheral neuropathy among people with diabetes attending a secondary care rural hospital in Southern India. J Family Med Prim Care 2013;2(1):27-32.
  • Desalu OO, Salawu FK, Jimoh AK. Diabetıc foot care: self reported knowledge and practıce among patıents attendıng three tertıary hospıtal ın Nigeria. Ghana Med J 2011;45(2):60-5.
  • Hasnain S, Sheikh NH. Knowledge and practices regarding foot care in diabetic patients visiting diabetic clinic in Jinnah Hospital, Lahore. J Pak Med Assoc 2009;59(10):687-90.
  • Aypak C, Koç A, Yıkılkan H, Görpelioğlu S. Diyabetik ayak bakımı: aile hekimliği polikliniğine başvuran hastalar tarafından bildirilen uygulama durumu. Cumhuriyet Tıp Dergisi 2012;34:423-8.
  • Abu-Qamar MZ. Knowledge and practice of foot self-care among Jordanians with diabetes: an interview-based survey study. J Wound Care 2014;23(5):247-50.
  • Lamchahab FZ, El Kihal N, Khoudri I, Chraibi A, Hassam B, Ait Ourhroui M. Factors influencing the awareness of diabetic foot risks. Ann Phys Rehabil Med 2011;54(6):359-65.
  • Batkın D, Çetinkaya F. Diyabetes mellitus hastalarının ayak bakımı ve diyabetik ayak hakkındaki bilgi, tutum ve davranışları. Journal of Health Sciences 2005;14(1):6-12.
  • Valk GD, Kriegsman DM, Assendelft WJ. Prognostic factors in treatment of diabetic foot ulceration. A systematic review. Endocrinol Metab Clin North Am 2002;31 (3):633-55.
  • Vatankhah N, Khamseh ME, Noudeh YJ, Aghili R, Baradaran HR, Haeri NS. The effectiveness of foot care education on people with type 2 diabetes in Tehran, Iran. Prim Care Diabetes 2009;3(2):73-7.
  • Schmidt S, Mayer H, Panfil EM. Diabetes foot self-care practices in the German population. J Clin Nurs 2008;17(21):2920-6.
  • Donohoe ME, Fletton JA, Hook A, Powell R, Robinson I, Stead JW, Sweeney K, Taylor R, Tooke JE. Improving foot care for people with diabetes mellitus--a randomized controlled trial of an integrated care approach. Diabet Med 2000;17(8):581-7.
  • De Berardis G, Pellegrini F, Franciosi M et al. Are type 2 diabetic patients offered adequate foot care? The role of physician and patient characteristics. J Diabetes Complications 2005;19(6): 319-27.
  • Dorresteijn JA, Kriegsman DM, Assendelft WJ, Valk GD. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev 2014;16:12.
  • Gale L, Vedhara K, Searle A, Kemple T, Campbell R. Patients’ perspectives on foot complications in type 2 diabetes: a qualitative study. Br J Gen Pract 2008;58:555-63.
  • Mason J, O’Keeffe C, McIntosh Mason J, O'Keeffe C, McIntosh A, Hutchinson A, Booth A, Young RJ. A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. I: prevention. Diabet Med 1999;16(10):801-12.
  • Valk GD, Kriegsman DM, AssendelftWJ. Patient education for preventing diabetic foot ulceration. Cochrane Database Syst Rev 2001;4:CD001488.
  • Viswanathan V, Shobhana R, Snehalatha C, Seena R, Ramachandran A.Need for education on footcare in diabetic patients in India. J Assoc Physicians India 1999;47(11):1083-5.
  • Pollock RD, Unwin NC, Connolly V. Knowledge and practice of foot care in people with diabetes. Diabetes Res Clin Pract 2004;64(2):117-22.
  • Khamseh ME, Vatankhah N, Baradaran HR. Knowledge and practice of foot care in Iranian people with type 2 diabetes. Int Wound J 2007;4(4):298-302.
  • Saleh F, Mumu SJ, Ara F, Begum HA, Ali L. Knowledge and self-care practices regarding diabetes among newly diagnosed type 2 diabetics in Bangladesh: a cross-sectional study. BMC Public Health 2012;12:1112.
  • Sriussadaporn S, Ploybutr S, Nitiyanant W, Vannasaeng S, Vichayanrat A. Behavior in self-care of the foot and foot ulcers in Thai non-insulin dependent diabetes mellitus. J Med Assoc Thai 1998;81(1):29-36.
  • Neil JA. Assessing foot care knowledge in a rural population with diabetes. Ostomy Wound Manage 2002;48(1):50-6.
  • Moreno Hernondez Mİ, Trilla Soler M, Esplerga Capdevilla A et al. Self-care and risk factors of diabetic foot in patients with type II diabetes mellitus. Aten Primaria 1997;20(4):185-90.
  • Lasker RD. The diabetic control and complications trial. Implications for policy and practice. N Eng J Med 1993;329(14):1035-6.
  • Özer E, Şengül AM, Gedik S, Salman S, Salman F, Sargın M, İşsever H, Yılmaz T. Diabetes Education:a chance to improve well being of Turkish people with type II diabetes. Patient Educ Couns 2003;51(1):39-44.
  • Ersoy C, Tuncel E, Özdemir B, Ertürk E, İmamoğlu Ş; İnsülin Kullanan Tip 2 DM’lu Hastalarda Diyabet Eğitimi ve Metabolik Kontrol, 2006. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006;32(2): 43-7.
  • Boyko E J, Ahroni JH, Cohen V, Nelson KM, Heagerty PJ. Predictable of Diabetic Foot Ulcer Occurence Using Commonly Available Clinical Information: The Seattle Diabetic Foot Study. Diabetes Care 2009;29(6):1202-7.
  • Carrington AL, Abbot CA, Griffiths J, Jackson N, Johnson SR, Kulkarni J, Van Ross ER, Boulton AJ. A foot care program for diabetic unilateral lower-limb amputees. Diabetes Care 2001;24: 216-21.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Bölüm Araştırmalar
Yazarlar

Didem Sunay Bu kişi benim

Feyza Yücel Bu kişi benim

Yayımlanma Tarihi 23 Eylül 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 16 Sayı: 3

Kaynak Göster

APA Sunay, D., & Yücel, F. (2016). Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care. Ankara Medical Journal, 16(3), 270-284. https://doi.org/10.17098/amj.53438
AMA Sunay D, Yücel F. Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care. Ankara Med J. Eylül 2016;16(3):270-284. doi:10.17098/amj.53438
Chicago Sunay, Didem, ve Feyza Yücel. “Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care”. Ankara Medical Journal 16, sy. 3 (Eylül 2016): 270-84. https://doi.org/10.17098/amj.53438.
EndNote Sunay D, Yücel F (01 Eylül 2016) Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care. Ankara Medical Journal 16 3 270–284.
IEEE D. Sunay ve F. Yücel, “Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care”, Ankara Med J, c. 16, sy. 3, ss. 270–284, 2016, doi: 10.17098/amj.53438.
ISNAD Sunay, Didem - Yücel, Feyza. “Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care”. Ankara Medical Journal 16/3 (Eylül 2016), 270-284. https://doi.org/10.17098/amj.53438.
JAMA Sunay D, Yücel F. Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care. Ankara Med J. 2016;16:270–284.
MLA Sunay, Didem ve Feyza Yücel. “Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care”. Ankara Medical Journal, c. 16, sy. 3, 2016, ss. 270-84, doi:10.17098/amj.53438.
Vancouver Sunay D, Yücel F. Assessment of Knowledge, Attitudes and Behaviours of Diabetic Patients About Diabetic Foot and Foot Care. Ankara Med J. 2016;16(3):270-84.