Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: A prospective study

• Published in: Diabetes research and clinical practice 2014-10, Vol.106 (1), p.67-72
• Main Authors: Vedhara, Kavita, Dawe, Karen, Wetherell, Mark A, Miles, Jeremy N.V, Cullum, Nicky, Dayan, Colin, Drake, Nicola, Price, Patricia, Tarlton, John, Weinman, John, Day, Andrew, Campbell, Rona
• Format: Article
• Language: English
• Subjects: Culture; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diabetic Foot - psychology; Diabetic foot ulcers; Endocrinology & Metabolism; Female; Health Behavior; Humans; Illness beliefs; Male; Middle Aged; Prospective Studies; Self Care - psychology; Self-care behaviours; Self-management
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2014.07.018

Abstract Aims Patients’ illness beliefs are known to be influential determinants of self-care behaviours in many chronic conditions. In a prospective observational study we examined their role in predicting foot self-care behaviours in patients with diabetic foot ulcers. Methods Patients ( n = 169) were recruited from outpatient podiatry clinics. Clinical and demographic factors, illness beliefs and foot self-care behaviours were assessed as baseline (week 0). Foot self-care behaviours were assessed again 6, 12 and 24 weeks later. Linear regressions examined the contribution of beliefs at baseline to subsequent foot self-care behaviours, controlling for past behaviour (i.e., foot self-care at baseline) and clinical and demographic factors that may affect foot self-care (i.e., age and ulcer size). Results Our models accounted for between 42 and 58% of the variance in foot self-care behaviours. Even after controlling for past foot-care behaviours, age and ulcer size; patients’ beliefs regarding the symptoms associated with ulceration, their understanding of ulceration and their perceived personal control over ulceration emerged as independent determinants of foot self-care. Conclusions Patients’ beliefs are important determinants of foot-care practices. They may, therefore, also be influential in determining ulcer outcomes. Interventions aimed at modifying illness beliefs may offer a means for promoting self-care and improving ulcer outcomes.