| Summary: | 碩士 === 國立成功大學 === 護理學系碩博士班 === 93 === Abstract
The purpose of this study is to investigate the factors that associated with foot ulceration in patients with diabetes. A case control study was conducted in a medical center at southern Taiwan. The studied factors included demographic characteristics, disease conditions, foot deformities, and structured questionnaires for diabetic foot-care knowledge, and foot-care behaviors. Sixty-one diabetic patients with foot ulcers and 122 diabetic patients without foot ulcers were recruited. SPSS software for windows version 11.0 was applied to analyze the data through descriptive statistic, chi-square, t-test, and logistic regression analyses.
The results indicated that the patients with foot ulcers were older, and had higher A1C level (9.68 ± 2.70 % vs. 7.80 ± 1.70 %, p = .000), longer diabetes history, and higher prevalence of retinopathy than those without foot ulcers. Patients with foot ulceration were also found to have higher prevalence of peripheral neuropathy, peripheral vascular disease, foot deformities, and abnormal dermatological conditions (p < .01), and lower diabetic foot-care knowledge and foot-care behavior scores ( p < .01) than those without.
The findings of multivariate logistic regression analysis suggested that peripheral neuropathy (OR, 20.27; 95% CI, 2.96-138.68; p = .002), peripheral vascular disease (OR, 5.67; 95% CI, 1.63-19.79; p = .007), dermatological conditions (OR, 17.58; 95% CI, 3.37-91.71; p = .001), A1C (OR, 1.47; 95% CI, 1.05-2.06; p = .025), and foot-care behavior (OR= .89, 95% CI = .84-.95; p = .000) are the independent prediction factors associated with development of diabetic foot ulcer.
The findings of this study clearly disclosed factors that related to diabetic foot ulceration that can be detected by simple non-intrusive instruments and structured questionnaires. Therefore, the patients with high risk of diabetic foot ulcers could be early recognized and treated to reduce the incidence of diabetic foot ulcer among the diabetes patients.
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