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Investigation of foot care knowledge and behaviour of older people with type 2 diabetes in Beijing community and analysis of influencing factors

Abstract

Good foot care knowledge and behaviour are very important to prevent the occurrence of diabetic foot, but there are few reports on the foot care knowledge and behaviour of older people with diabetes in the community. The purpose of this study was to understand the foot care knowledge and behaviour of older people with type 2 diabetes in Beijing community, and analyse its influencing factors, so as to provide reference for further intervention. We investigated 254 older people with type 2 diabetes in Xinjiekou community, Beijing, including their general information, chronic complications, foot care knowledge and behaviour. The results showed that the average scores of foot care knowledge and behaviour were 73.38 ± 12.25 and 49.70 ± 8.70, respectively. Multiple stepwise regression analysis showed that the factors affecting the total score of foot nursing knowledge of older people with diabetes in community were gender, duration of diabetes and whether they had received foot nursing education (p < 0.05). The factors influencing the total score of foot nursing behaviour were gender, duration of disease, whether they had received foot nursing education and peripheral vascular disease (p < 0.05). In conclusion, the knowledge of foot care of older people with diabetes in community is in the middle level, and the foot care behaviour is not optimistic. Community healthcare workers can improve patients' knowledge of foot care and improve their compliance with foot care behaviour through foot care health education. At the same time, we should pay more attention to men, those with a shorter duration of diabetes and diabetic patients with peripheral vascular disease to reduce the occurrence of diabetic foot.

Factors associated with health behaviours among stroke survivors: A mixed‐methods study using COM‐B model

Abstract

Aims

To identify factors associated with health behaviours among stroke survivors, through a multi-centre study.

Design

A sequential mixed methods design.

Methods

In the quantitative research phase, a total of 350 participants were recruited through multi-stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF-HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL-BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi-structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines.

Results

A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF-HBMS and WHOQOL-BREF. Twenty-four individuals participated in qualitative interviews. Twenty-eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM-B model (Capability, Opportunity, Motivation and Behaviour).

Conclusion

The study indicates that key barriers to health behaviour among stroke survivors align with the COM-B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors.

Patient or Public Contribution

Patients were invited to completed questionnaires in the study and semi-structured interviews. The investigators provided explanation of this study’ content, purpose and addressed issues during the data collection.

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