Examination of the Relationship Between Foot Care Behaviour, Self‐Efficacy, and Diabetes Self‐Care Among Individuals With and Without Diabetic Foot Wounds

AIM: This study aimed to examine the relationship between foot care behaviours, self-efficacy and diabetes self-care activities among individuals with and without diabetic foot wounds and to identify associated sociodemographic and disease-related factors. METHODS: A cross-sectional study was conducted with 120 patients presenting to the internal medicine, endocrinology, and diabetic foot outpatient clinics and wards of three different hospitals. Data were collected using a demographic and clinical characteristics form, the Foot Care Behaviour Scale, Diabetic Foot Care Self-Efficacy Scale, and Diabetes Self-Care Scale. Data were analysed using IBM SPSS version 22, with Mann-Whitney U, Kruskal-Wallis H, independent samples t-test, ANOVA and correlation analysis applied as appropriate. RESULTS: Patients with and without diabetic foot wounds did not differ significantly in foot care behaviours or diabetes self-care scores (p > 0.05). However, diabetic foot care self-efficacy scores were significantly higher among patients without diabetic foot wounds (p < 0.05). In patients with diabetic foot wounds, prior foot care education was associated with significantly higher diabetic foot care self-efficacy and diabetes self-care scores (p < 0.05). Older age was negatively correlated with scale scores in both groups, whereas higher education level and certain preventive practices (e.g., foot self-examination, checking footwear) were significantly associated with better scores. Strong positive correlations were identified among foot care behaviours, diabetic foot care self-efficacy, and diabetes self-care across all participants (p < 0.05). CONCLUSION: The strong positive associations among foot care behaviours, diabetic foot care self-efficacy, and diabetes self-care underscore the critical role of patient empowerment in disease management. The higher self-efficacy scores in patients without diabetic foot and those who were previously educated on their prevention demonstrate the importance of early, targeted nursing interventions. Implementing structured foot care education prior to the onset of complications may strengthen patient self-efficacy, improve self-care adherence and ultimately prevent the development of diabetic foot wounds.