Table 4.
Nurses' Knowledge Level Form on Diabetic Foot Management.
| RISK FACTORS | True | False | ||
| n | % | n | % | |
|
| ||||
| (1) Poor glycemic control | 428 | 98.4 | 7 | 1.6 |
| (2) Presence of sense of chill, pain, burning, tingling, and tenderness in foot | 408 | 93.8 | 27 | 6.2 |
| (3) Neuropathic foot (loss of sensory-motor function) | 417 | 95.9 | 18 | 4.1 |
| (4) Peripheral vascular disease | 369 | 84.8 | 66 | 15.2 |
| (5) Inadequate foot care and lack of hygiene | 409 | 94.0 | 26 | 6.0 |
| (6) Presence of foot edema | 379 | 87.1 | 56 | 12.9 |
| (7) Presence of foot callus | 340 | 78.2 | 95 | 21.8 |
| (8) Dry and cracked foot skin | 362 | 83.2 | 73 | 16.8 |
| (9) Those with diabetic foot history or diabetic ulcers in opposite extremity | 423 | 97.2 | 12 | 2.8 |
| (10) Infection (redness, tenderness, and temperature increase are present in foot) | 423 | 97.2 | 12 | 2.8 |
| (11) Traumas (barefoot walking, bad shoes, accident, foreign body in shoes) | 387 | 89.0 | 48 | 11.0 |
| (12) Foot deformity (mallet toes, claw toes, hallux valgus, amputation, Charcot deformity, low foot, etc.) | 377 | 86.7 | 58 | 13.3 |
| (13) Smoking | 404 | 92.9 | 31 | 7.1 |
| (14) Obesity | 393 | 90.3 | 42 | 9.7 |
| (15) Age of 65 and over | 377 | 86.7 | 58 | 13.3 |
| (16) Patients not trained in diabetic foot | 407 | 93.6 | 28 | 6.4 |
|
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| FOOT EXAMINATION | ||||
|
| ||||
| (1) Foot skin (color change, edema-atrophy, dryness, crack, callus, ulcer, etc.) is evaluated. | 428 | 98.4 | 7 | 1.6 |
| (2) Color control (pale, cyanosis, red) is made. | 434 | 99.8 | 1 | 0.2 |
| (3) Temperature control (temperature, coldness) is made. | 425 | 97.7 | 10 | 2.3 |
| (4) Presence of neuropathy in foot (pain, tingling, burning, tenderness, sensory loss) is evaluated. | 426 | 97.9 | 9 | 2.1 |
| (5) Muscle functions (atrophy due to motor damage in the muscles) are assessed. | 367 | 84.4 | 68 | 15.6 |
| (6) Circulatory control (foot is pale and cyanosis) is made. | 426 | 97.9 | 9 | 2.1 |
| (7) Presence of ulcer on foot (temperature increase in foot, redness, edema, and tenderness) is evaluated. | 431 | 99.1 | 4 | 0.9 |
| (8) Presence of deformity (hammer finger, claw, hallux valgus, amputation, Charcot deformity, low foot, etc.) is evaluated. | 382 | 87.8 | 53 | 12.2 |
| (9) Toenails (thickening, ingrowth, and length in the nails) are controlled. | 392 | 90.1 | 43 | 9.9 |
| (10) Shoe suitability is assessed. | 407 | 93.6 | 28 | 6.4 |
|
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| APPLICATIONS FOR PREVENTING FOOT COMPLICATIONS | ||||
|
| ||||
| (1) Feet should be checked every day by the patient or a relative by eye, hand, and mirror (callus, crack, redness, bulla, open wound, etc.). | 430 | 98.9 | 5 | 1.1 |
| (2) Feet should be washed with warm water every day. | 414 | 95.2 | 21 | 4.8 |
| (3) The water temperature used for washing feet should be checked. | 421 | 96.8 | 14 | 3.2 |
| (4) Feet, especially spaces between toes, should be dried very well after each wash. | 424 | 97.5 | 11 | 2.5 |
| (5) Moisturizing cream should be applied to feet. | 405 | 93.1 | 30 | 6.9 |
| (6) Moisturizing cream should be applied to spaces between toes. | 113 | 26.0 | 322 | 74.0 |
| (7) Toes should be kept dry to protect from fungal growth. | 425 | 97.7 | 10 | 2.3 |
| (8) Cutting tools and chemicals should not be used to remove calluses or hardened skin areas. | 415 | 95.4 | 20 | 4.6 |
| (9) Callus and skin stiffness should be thinned with a pumice stone. | 348 | 80.0 | 87 | 20.0 |
| (10) Exercise in the form of twisting and stretching toes several times a day should be done to prevent foot corn and callus formation. | 383 | 88.0 | 52 | 12.0 |
| (11) There is no inconvenience to use callus band and plaster | 127 | 29.2 | 308 | 70.8 |
| (12) Only socks should be worn to warm feet. | 397 | 91.3 | 38 | 8.7 |
| (13) Direct heat sources (radiators, hot-water bottle, electrical appliances, etc.) should be used to warm feet. | 216 | 49.7 | 219 | 50.3 |
| (14) Socks should not be torn, wrinkled, or oversized. | 415 | 95.4 | 20 | 4.6 |
| (15) Socks should be checked for wetness and color darkness. | 416 | 95.6 | 19 | 4.4 |
| (16) Socks should be changed every day. | 425 | 97.7 | 10 | 2.3 |
| (17) Rubber socks preventing circulation should not be worn. | 425 | 97.7 | 10 | 2.3 |
| (18) Wool socks should be worn in winter and mercerized socks should be worn in summer. | 398 | 91.5 | 37 | 8.5 |
| (19) Walking with bare feet should not occur. | 406 | 93.3 | 29 | 6.7 |
| (20) Pressure on feet should be removed by not standing for long periods. | 422 | 97.0 | 13 | 3.0 |
| (21) Legs should not be crossed when sitting on a chair. | 407 | 93.6 | 28 | 6.4 |
| (22) If there is clawing of toes, massage should not be done to prevent joint stiffness. | 83 | 19.1 | 352 | 80.9 |
| (23) Toenails should be controlled in terms of thickening, ingrowth, and length. | 420 | 96.6 | 15 | 3.4 |
| (24) Toenails should be cut flat. | 394 | 90.6 | 41 | 9.4 |
| (25) Skin around toenails should not be cut. | 419 | 96.3 | 16 | 3.7 |
| (26) The thickened nails should be cut with a special scissors after they are softened in warm water. | 414 | 95.2 | 21 | 4.8 |
| (27) Blind patients must never cut their own toes. | 422 | 97.0 | 13 | 3.0 |
| (28) The nails should be cut round. | 190 | 43.7 | 245 | 56.3 |
| (29) Any changes to feet and toes (color, temperature, or shape) and signs of infection should be reported to the doctor immediately. | 422 | 97.0 | 13 | 3.0 |
| (30) Foot exercises should be done every day to help circulation. | 410 | 94.3 | 25 | 5.7 |
| (31) In case of any foot lesion, only shoes should be replaced to reduce the load on feet. | 87 | 20.0 | 348 | 80.0 |
| (32) Smoking is strictly forbidden since it will reduce the amount of blood going to feet. | 423 | 97.2 | 12 | 2.8 |
|
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| FOOTWARE SELECTION | ||||
|
| ||||
| (1) Shoes should fit and grasp feet. | 416 | 95.6 | 19 | 4.4 |
| (2) Soft-skinned and comfortable shoes should be preferred. | 417 | 95.9 | 18 | 4.1 |
| (3) Shoes should be checked for foreign bodies such as nail, gravel, etc. before each wear. | 414 | 95.2 | 21 | 4.8 |
| (4) Shoes should be worn without socks. | 198 | 45.5 | 237 | 54.5 |
| (5) If shoe insoles are worn off, they should be replaced. | 411 | 94.5 | 24 | 5.5 |
| (6) Shoes should not lose its exterior protection feature. | 397 | 91.3 | 38 | 8.7 |
| (7) Shoes should be painted frequently. | 295 | 67.8 | 140 | 32.2 |
| (8) New shoes should be worn by allowing feet to get used to them. | 405 | 93.1 | 30 | 6.9 |
| (9) High-heeled shoes tapering forward should be preferred. | 211 | 48.5 | 224 | 51.5 |
| (10) If there is a deformity in the foot, a doctor should be consulted for proper treatment or orthopedic shoes. | 421 | 96.8 | 14 | 3.2 |
Note: the correct answers were indicated by using bold font for “n”.