Self-efficacy, Knowledge and Outcomes Expectations Foot Self-care among Diabetic Patients with High-Risk Feet in Jordan.

Background: Patients with high-risk feet and diabetes are prone to develop diabetes-related foot ulcers (DFUs). To prevent DFUs and their costs and impacts on diabetes mellitus (DM) patients' productivity and quality of life, patients' foot self-care (FSC) practices are essential to screen for DFUs. Our study aimed to assess the self-efficacy and outcome expectations about FSC and evaluate the knowledge about DFUs among patients with DM in Jordan.

Methods: A cross-sectional study was conducted with DM patients who attended two diabetes clinical centers in Jordan in the period from October 2022 to April 2023 in which data were collected through a self-administered questionnaire developed to assess patients' understanding of DFUs, foot care outcomes expectations (FCOE), and self-efficacy about FSC.

Results: The final sample included data from 107 patients. Patient awareness of DFUs and FCOE was good, and the level of self-efficacy for FSC was moderate to high. Multiple linear regression revealed that age was negatively associated with lower self-efficacy for FSC (β = -0.22, p = 0.03) and both confidence (self-efficacy) in FSC and living arrangements (i.e., living with family) were positively associated with higher FCOE (β = 0.19, p = 0.04 and β = 0.39, p <0.001, respectively). Diagnosis of renal failure, diagnosis of retinopathy, elevated levels of glycated hemoglobin, and the settings in which the patient is receiving care for DM were positively associated with an understanding of DFUs. Both age and history of heart attacks and coronary artery disease were negatively associated with realizing DFUs (β = -0.26, p = 0.007, and β = -0.18, p = 0.045, respectively).

Conclusion: Patients with diabetes mellitus in Jordan have good FCOE, good awareness of DFUs, and a moderate degree of self-efficacy to execute FSC. Health education and self-efficacy programs should focus on older adults with a history of heart attacks to boost their understanding of DFUs and raise their sense of self-efficacy around FSC.