Screening behaviors for diabetic foot risk and their influencing factors among general practitioners: a cross-sectional study in Changsha, China

Nan Zhao; Jingcan Xu; Qiuhong Zhou; Juanyi Hu; Wenjing Luo; Xinyi Li; Ying Ye; Huiwu Han; Weiwei Dai; Qirong Chen

doi:10.1186/s12875-023-02027-3

Screening behaviors for diabetic foot risk and their influencing factors among general practitioners: a cross-sectional study in Changsha, China

BMC Prim Care. 2023 Mar 13;24(1):68. doi: 10.1186/s12875-023-02027-3.

Authors

Nan Zhao^{1

2}, Jingcan Xu^{3

4}, Qiuhong Zhou⁵, Juanyi Hu⁶, Wenjing Luo¹, Xinyi Li¹, Ying Ye^{1

6}, Huiwu Han^{1

7}, Weiwei Dai^{1

8}, Qirong Chen⁶

Affiliations

¹ Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, 410008, Changsha, China.
² Department of Nursing, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi Province, China.
³ Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, 410008, Changsha, China. [email protected].
⁴ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China. [email protected].
⁵ Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, 410008, Changsha, China. [email protected].
⁶ Xiangya School of Nursing, Central South University, 410013, Changsha, China.
⁷ National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 410008, Changsha, Hunan, China.
⁸ Department of Stoma Wound Care Center, Xiangya Hospital, Central South University, 410008, Changsha, China.

Abstract

Background: Diabetic foot is a serious complication of diabetes with a high disability and mortality rate, which can be prevented by early screening. General practitioners play an essential role in diabetic foot risk screening, yet the screening behaviors of general practitioners have rarely been studied in primary care settings. This study aimed to investigate foot risk screening behaviors and analyze their influencing factors among general practitioners.

Methods: A cross-sectional study was conducted among 844 general practitioners from 78 community health centers in Changsha, China. A self-designed and validated questionnaire was used to assess the general practitioner's cognition, attitude, and behaviors on performing diabetic foot risk screening. Multivariate linear regression was conducted to investigate the influencing factors of risk screening behaviors.

Results: The average score of diabetic foot risk screening behaviors among the general practitioners was 61.53 ± 14.69, and 271 (32.1%) always or frequently performed foot risk screening for diabetic patients. Higher training frequency (β = 3.197, p < 0.001), higher screening cognition (β = 2.947, p < 0.001), and more positive screening attitude (β = 4.564, p < 0.001) were associated with more diabetic foot risk screening behaviors, while limited time and energy (β=-5.184, p < 0.001) and lack of screening tools (β=-6.226, p < 0.001) were associated with fewer diabetic foot screening behaviors.

Conclusion: The score of risk screening behaviors for the diabetic foot of general practitioners in Changsha was at a medium level. General practitioners' diabetic foot risk screening behaviors may be improved through strengthening training on relevant guidelines and evidence-based screening techniques, improving cognition and attitude towards foot risk screening among general practitioners, provision of more general practitioners or nurse practitioners, and user-friendly screening tools.

Keywords: Behavior; Diabetic foot; General practitioner; Risk screening.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China
Cognition
Cross-Sectional Studies
Diabetes Mellitus*
Diabetic Foot* / diagnosis
General Practitioners*
Humans