Published Paper Details:

Diabetes foot ulcers represent the first cause of hospitalization in diabetics and a significant cause of health care costs (more than 20%-40% of health care resources have been reported as related to diabetes-related foot care). According World Health Organization, its' possible encompass all foot complications in the term diabetic foot syndrome (DFS) that has been defined as "ulceration of the foot (distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection". These foot vascular complications represent a very common precursor event prior of lower extremity amputation among persons with diabetes. Thus, it explains that the foot ulcerations are considered as significantly predictive of morbidity, mortality, and disability in the world as well as in Bangladesh.However, the present study has conducted to determine the level of patients' knowledge towards diabetes foot ulcer, to identify the factors associated with different level of knowledge and practices of foot ulcer and to examine the relationship between patients' knowledge & practices towards diabetes foot ulcer. This study was a non-experimental descriptive type of cross-sectional study. It was used to examine the patients' knowledge and practices regarding diabetes foot ulcer. This study was conducted two public hospitals, one is Khulna medical college hospital and another one is diabetes hospital in Khulna. The target populations of this study were patients' who were admitted in hospital. A total 220 patients employed in surgical ward and dressing room of outpatient department (OPDs) who are directly involve in diabetes wound care management for more than 6 months will be recruit for the study. The participation will be entirety voluntary. Simple random sampling was used for data collection. Data were collected from primary and secondary sources. Primary data were collected from the respondent of the study area. Secondary data were collected from the secondary sources. The data collection tools were divided into three parts. Part one was patients' Demographic Data Form; Part two were patients' Knowledge regarding foot ulcer questionnaire; and Part three were Practice regarding foot ulcer questionnaire. The questionnaires were hand deliver to ensure a higher response rate. The complete questionnaires were collected on the same day within 4 hours of distribution to improve data quality. The investigators were checking all questions for completeness. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 21. From the result it was found that poor glycemic control, inappropriate foot care and smoking as important risk factors of diabetic foot ulcer. The study revealed that residence, level of education, occupation, number of family members and monthly family expenditure were significantly different between cases and controls. It was that most of the component parts of foot care were significantly associated with development of diabetic foot ulcer. Neither duration of foot examination at home nor presence of any foot complications before diabetes made any significant difference between the two groups for the development of diabetic foot ulcer. Smoking habit, early start of smoking along with increased duration was significantly associated with development of diabetic foot ulcer. Level of HbA1c, measuring indicator for glycaemic status of the respondent in this study, was found significantly varied between the two study groups for the development of diabetic foot ulcer along with other influencing factors like types of diabetic management, regularity of treatment, exercise habit and food habit. Confounders like serum lipoproteins, BMI of the respondent and other diabetic complications were found insignificant except diabetic neuropathy. A physician can play the most vital role by giving proper foot care education to the diabetic individuals about the risk factors and how to prevent them and early diagnosis of the problem along with prompt treatment to decrease the burden.The government should allocate adequate resources and manpower to prevent or minimize the problem before it becomes out of control. As it is not possible to reverse the situation once this foot ulcer has been established, diabetic patients must be careful about the possible risk factors of diabetic foot ulcer.