Personal and treatment factors associated with foot self-care among veterans with diabetes

J Rehabil Res Dev. Mar-Apr 2006;43(2):227-38. doi: 10.1682/jrrd.2005.06.0106.


We developed and validated a survey of foot self-care education and behaviors in 772 diabetic patients with high-risk feet at eight Department of Veterans Affairs medical centers. Principal components analysis identified six subscales with satisfactory internal consistency: basic foot-care education, extended foot-care education, basic professional foot care, extended professional foot care, basic foot self-care, and extended foot self-care (alpha = 0.77-0.91). Despite high illness burden, adherence to foot self-care recommendations was less than optimal; only 32.2% of participants reported looking at the bottom of their feet daily. Independent predictors of greater adherence to basic foot self-care practices included African-American or Hispanic background, perceived neuropathy, foot ulcers in the last year, prior amputation (beta = 0.08- 0.12, p < 0.04-0.001), and provision of greater basic and extended education (beta = 0.16, p < 0.004, and beta = 0.15, p < 0.007). The survey subscales can now be used for evaluating foot care and education needs for persons with high-risk feet.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Attitude to Health*
  • Data Collection
  • Diabetic Foot / physiopathology
  • Diabetic Foot / therapy*
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Education as Topic*
  • Personality
  • Predictive Value of Tests
  • Risk Assessment
  • Self Care / methods*
  • Severity of Illness Index
  • Socioeconomic Factors
  • Veterans