TDNet Discover

Background: Approximately 19-34% of patients living with diabetes will develop subsequent foot ulcers, and nearly 80 billion dollars is spent on the treatment of diabetic foot ulcers. Both the incidence of diabetes and diabetic foot ulcers is expected to rise in the future. Most research has focused on the prevention of diabetic foot ulcers or the patient's capability to manage them rather than patient motivations to follow through with treatment plans. Purpose: This research sought to address the potential relationship between patient self-efficacy on diabetic foot ulcer wound healing and recurrence. The researchers hypothesized that there is no statistically significant difference (p<0.05) in the progression of wounds for adults in Appalachia with diabetes who have high versus low self-efficacy. Methods: A convenience sample in-person interview was conducted to evaluate patient selfefficacy of diabetic wound care. Wound tracking was completed by comparing the relative healing of a wound over time. Surveyed interests included general demographics, control of diabetes mellitus, preventative behaviors, and understanding the risks of uncontrolled diabetes mellitus. Survey responses were categorized into ranges when appropriate and underwent analysis by an independent statistician using Intellectus software. Descriptive statistics included frequency, mean, and standard deviation. Results: There were 24 patients included with most being older white males who did not smoke or drink. This research found that patient self-efficacy has no relationship on their wound healing as demonstrated by the lack of significant correlations between their level of confidence to take care of their wounds (based on their average self-reported self-efficacy ratings) and changes in wound size, level of drainage, and color as well as their overall Wagner classification. There was a significant positive correlation between confidence in caring for your feet and confidence in v ability to prevent DFUs. Another significant positive correlation was observed between confidence in foot care and the level of education on diabetes they received as well as confidence in prevention of complications and level of education on diabetes. Finally, a significant positive correlation was observed between the reported level of education on diabetes and their confidence in their understanding of the risk of not controlling diabetes. Conclusion: In this research the null hypothesis failed to be rejected, concluding there is no statistically significant difference in the progression of wounds for adults in Appalachia with diabetes who have varied levels of self-efficacy. However, higher levels of education on diabetes are correlated with more confidence in foot care, understanding of the risk of not controlling diabetes, and prevention of future DFUs. The research findings should not be applied to the greater population due to the small sample size. Future studies should improve patient recruitment to provide larger sample sizes.