الفهرس 
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Abstract
Conclusion & Recommendations
Conclusion:
A multidisciplinary approach is required for the management of diabetes mellitus, involving a community doctor, dietitian, diabetic nurse, and a community-based education program. As part of a multidisciplinary team effort, foot care education should be provided from primary care settings up to tertiary care facilities. This is even more crucial in a resource-constrained nation like Egypt.
Additionally, for the patient to improve clinical results in diabetes, a variety of self-care behaviors include taking medication, checking blood glucose levels, adhering to any food plan, exercising frequently, and taking care of the foot must be initiated and maintained. Additionally, patients, their families, and other members of the healthcare team must actively participate in the management of diabetes for it to be effective.
We draw the conclusion that the knowledge and practice levels are less than ideal. As a result, there is a need for systematic programs to change patients’ attitudes and behaviors. This can be done through improving the standard and breadth of MOH-level health education. To corroborate the findings, studies with a larger sample size and a broader focus are advised.
This study has brought attention to the knowledge and practice gaps in DM patients’ foot care, underscoring the need for an educational program to prevent diabetic foot complications, which were linked to poor socioeconomic status and illiteracy.along with ongoing assistance and reinforcement from doctors
Older persons don’t seem to use foot self-care routines as key preventative strategies, only doing them after significant foot problems have already occurred. Similarly, it appears that persons who have already had foot issues are the only ones who can benefit from foot self-care behaviors enablers like education. By identifying, recommending, and giving older persons early education, general practitioners and family doctors may play a significant part in the prevention of foot issues in older adults. Given the financial impact of diabetic complications, it is possible to develop a campaign to raise awareness of the disease and encourage prevention.
The quality of foot self-care practices and self-care management for type 2 DM patients increases with patient knowledge, motivation, and self-efficacy. Therefore, DM treatment must be more proactive in educating patients so that their knowledge or that of their family members can grow and comprehend how to control diabetes appropriately.
All primary healthcare facilities and hospitals need to encourage and implement staff and patient education in order to increase diabetic patients’ awareness of and practice with foot care.
This study brought to light the variables we must take into account when creating health promotion initiatives. Additionally, it is necessary to construct health literacy, counseling, and education programs in both clinical and community settings. Our findings indicate that in order to better promote health, diabetic health literacy has to be established or increased. Retain knowledge with a group-based course on diabetic feet.
In order to improve their lifestyle and behaviors and adopt durable adjustments for better diabetes control, patients need the ongoing support of their family and community. Additionally, information about diabetes mellitus and its risk factors should be disseminated through the media in order to effectively control it in the community. This is especially important for patients who live in remote areas, so we should start an interventional foot care education program across the entire regional state. Individualized foot care instruction must take into account the patient’s age, level of education, employment position, length of diabetic therapy, and other characteristics. Additionally, patients should look for convenient alternatives to barefoot working since the risk surpasses the benefit rather than disregarding this while at work.
Ineffective patient-nurse and physician communication, inadequate knowledge, inconvenience at work, and. Inaccessibility and lack of availability of health services were frequently cited as obstacles to proper foot care.
In order to avoid diabetic neuropathy and vascular insufficiency consequences, diabetic foot care is crucial. Even in the face of significant risk factors for lower limb problems, a significant portion of diabetic patients do not receive proper foot care. (Bijoy et al., 2012).
Recommendations
The main improvement suggested for the current health prevention/promotion campaign offered by the involved public sector is learning from the study’s findings in order to increase patients’ practice of preventive behaviors regarding foot ulcers. This is in response to the Principle of Primary Health Care, which calls for health prevention and promotion by the citizens themselves. A doctor’s busy schedule prevents him or her from giving these essential details due to the overflow of people at hospitals or clinics.
Every diabetes outpatient clinic should have a diabetic educator staff, and in medical indoor departments as well. This can be accomplished through patient education, which can be done by primary care physicians and family physicians since they have stronger patient communication skills. This study, in our opinion, is significant in that it highlights the significance of foot self-care and highlights the fact that patient education is still insufficient.
The Egyptian government should promote citizens’ health and well-being in order to reduce the high costs of medical treatment for these diseases as well as to gain productive and qualideif citizens as a result. Community participation can help implement an effective self-care program by taking into account area-based problems, covering local characteristics, felt needs, local culture, local history and background, as well as local resources. Their prior education session’s lessons encourage them to take care of their feet every day and assist them in overcoming any obstacles they may encounter while doing so.
-More time for discussion or questions & answers at the end of the session (if needed)
- Facilitate dialogue and interaction during the lecture or discussion session between participants and between the presenter (the research) and the audience.
-Ensure food safety and a serving that is appropriate for diabetic patients (the researcher met with a dietitian and a diabetes specialist in the Nutrition Center; a serving should serve as an illustration of a healthy snack for diabetic patients).
Summary
Summary
The assessment of knowledge and foot self-care practices is very important. Due to the rising prevalence of DM worldwide and the increased life expectancy of DM patients, there are now more cases of diabetic foot.However, professional monitoring through educational activities aimed at the development of self-care skills, such as, for example, daily inspection of the feet, hygiene, appropriate use of footwear, and adherence to treatment to control the disease, can reduce the increased risk for diabetic foot and, consequently, for amputations.
The development of diabetic foot ulcers can be avoided with well-planned foot care services. To identify at-risk feet, implement early intervention, and provide ongoing foot care education to patients and healthcare professionals, it is vital to establish coordinated foot care services inside the diabetes clinic. As minimal diabetic foot damage
There is a strong correlation between existing foot care practices and low levels of diabetic foot care education. The main obstacle to inadequate foot care practices is incomplete information regarding foot care.
Studying knowledge, practice and barriers of diabetic patients regarding foot care in Sohag University was accomplished in this study including 200 diabetic patients at endocrine outpatient clinic. We used questionnaire consisting of four sections:
• Demographic section
• Knowledge related questions regarding foot care
• Practice related questions regarding practice of foot care
• Barrier related questions regarding practice of foot care
This study included all the diabetic patients attending endocrine outpatient clinic at Sohag University. During the duration of the study 200 patients 108 males, and 92 females with type 2 diabetes ,the study participants were aged between 30 and 70 years old , they were mainly from rural areas (127) participants and to less extent from urban 73 participants and most of them were married (134 participants) and (36 single ones).Their educational level showed that majority of respondents were of middle and primary education .The majority of them were having no job and also The majority of them had monthly income less than 5,000 pound and that was insufficient.
The results of the current study revealed that the total mean knowledge score was (2.9±2.0). The total mean practice score was (5.9±2.8)
Several factors were found to affect knowledge and practice among diabetic patients as gender; females had higher practice scores than males, and knowledge score was statistically significantly higher in females than males.
As regardst he residence of participants,There was no statistically significant difference between rural and urban patients.
There was no correlation between the score of knowledge and age. but there was a statistically significant negative correlation between practice score and age.
The major strategy for guaranteeing self-care is DM self-management education. The major goals of this approach are to lower barriers between people with the condition and their families, communities, and healthcare professionals; to enable people to take care of themselves.
Therefore, we advise that primary care physicians and family physicians continue their current health prevention and promotion campaigns to encourage patients to take foot care everyday and to assist them in overcoming any challenges they may have when performing foot care at home.
Nursing consultations, as well as the design and execution of educational actions which aimed at the acquisition and improvement of self-care habits, are likely to benefit from the inclusion of nurses in the clinical practice at primary care.