Factors related to self-care behaviours among patients with diabetic foot ulcers.

AIMS AND OBJECTIVES: To examine the level of self-care behaviours among patients with diabetic foot ulcers and identify factors related to their self-care behaviours. BACKGROUND: This study focused on the self-care behaviours of patients diagnosed with diabetic foot ulcers, a complication of diabetes. DESIGN: A cross-sectional study design was adopted. METHODS: From July-August 2018, 131 outpatients and inpatients with diabetic foot ulcers were given a survey questionnaire regarding self-care behaviours and expected related factors at two Korean hospitals. In this study, self-care behaviours were diabetes management and diabetic foot care. Demographic, disease-related and laboratory characteristics were collected. The data were analysed in terms of descriptive statistics, a t test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. STROBE checklist was used as the guideline for this study. RESULTS: Moderate levels of self-care behaviours were found. The stepwise multiple regression analysis revealed that diabetes management was significantly related to perceived family support, experience of diabetic education, perceived stress, a problem-focused coping style, experience of hospitalisation and comorbidity. Furthermore, diabetic foot care was significantly associated with the experience of diabetic education, perceived family support, and serum level of erythrocyte sedimentation rate and haemoglobin A1C. CONCLUSIONS: Perceived family support was the main factor affecting diabetes management, and diabetic foot care was greatly affected by the experience of diabetic education. It is necessary to develop diabetes education programmes and nursing interventions to increase family support to improve the self-care behaviours of patients with diabetic foot ulcers. RELEVANCE TO CLINICAL PRACTICE: Self-care behaviours among patients with diabetic foot ulcers are important, as they affect healing of the wound and the quality of life. Further development of family-based diabetes education or programmes is recommended to promote the self-care behaviours of patients with diabetic foot ulcers.

Self-Care in Korean Immigrants with Chronic Diseases: A Concept Analysis.

Chronic illnesses among Korean immigrants (KIs) in the United States have been rapidly increasing, yet the concept of chronic disease self-care in this group has not been delineated. The aim of this study was to review previous research on self-care among KIs with chronic diseases and describe the concept in cultural context. Using Rodgers' Evolutionary Method, a total of 24 articles were analyzed. The definition and conceptual model of self-care in KIs with chronic diseases were proposed. The antecedents included knowledge and health literacy; social and family support; resources; patient-health care provider partnership; and elimination of cultural misbeliefs and disclosure of the disease. The attributes of the concept were aging well with diseases; treatment adherence; control and restriction; the acculturation process; care built on traditional Korean gender roles; and maintenance of mental health. The consequences involved positive physiological outcomes; self-efficacy; quality of life; and reducing worry about becoming a burden to the family. While the studied concept encompassed universal characteristics of chronic disease self-care, distinctive cultural features emerged. The findings contribute to a better understanding of chronic illness self-care in this population and the development of culturally sensitive and practical self-care interventions for KIs with chronic diseases.