Family Medicine

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    Knowledge, attitude, and practices on diabetic foot care among nursing staff at primary health care facilities in Sol Plaatje sub-district, Kimberley
    (University of the Free State, 2020-08) Mafusi, Labala Guy Juste; Steinberg, W. J.; Harmse, M. C.
    As essential team members of the healthcare system, nurses have more contact with the patients and are indispensable in patients' education. They can ameliorate diabetic patients' quality of life by aiding in preparing and implementing educational programs that assist patients in growing self-care behaviours associated with diabetic foot care. Furthermore, they can stop or prevent diabetic foot problems by pointing out risk groups in the community. To reduce Diabetic Foot Disease's load sensibly, improve patient education and preventive and screening programmes on Diabetic Foot Care, healthcare providers need to be knowledgeably possessing the right attitude, which is crucial in offering any meaningful advice to their clients. Positive attitudes, combined with sound knowledge, prevent compromising health care standards. However, for nurses to efficiently offer education, they need organised training programs combining theory and practice. Nurses involved in the management of diabetes-related foot problems must be encouraged to take part in these programs. Objectives: To assess the knowledge, attitude, and practice of nursing staff regarding diabetic foot care in Sol Plaatje primary healthcare centres in the Northern Cape. Methodology: The researcher used a descriptive cross-sectional study with a self-administered questionnaire to assess the knowledge, practice, and nursing staff attitude on diabetic foot care. A total number of one hundred and twenty-eight nurses providing primary care to patients within the Sol-Plaatje sub-district were targeted to participate in the study from three groups: professional nurses, enrolled nurses, and auxiliary nurses. Results: Responses were received from 105 participants constituting 82% of the targeted population. Of the participants, 88% were professional nurses, and the majority, 95%, were female; the median age was 48 years and the median year of practice was 15 years. The results showed that 58% of this sample had a good knowledge of South African Diabetic foot guidelines even though compliance level was low, highlighting a lack of training on diabetic foot care with 86% needing diabetic foot care training whilst 94% knew the importance of foot assessment on diabetic patients. The majority, 59%, did not know the importance of diabetic foot prevention and 57% did not know of the 60-Second Screening Tool for high-risk diabetic foot, and 70% did not know about the 10g monofilament tool used for foot neurology check. 98% expressed that diabetic foot education is an essential part of their job, yet only 46% indicated that they record foot examination, whilst 82% do not do a 60-Second comprehensive assessment. The majority, 91% of Nurses displayed a positive attitude towards caring for diabetic foot patients despite 59% of poor screening attitude. Also, the knowledge of specialist referrals was insufficient among nurses. Conclusions: This study revealed that most frontline healthcare providers (nurses) in Sol Plaatje Sub-District are aware of the diabetic foot guideline for primary care in contrast to the majority not being aware of the 60-Second Screening Tool for high-risk diabetic foot and the 10g monofilament tool. It was also noted that respondents agree that diabetic foot education is an essential part of their jobs. Nurses do not regularly record patient diabetic foot examination findings. They also requested training in diabetic foot care. Poor screening attitude may be attributed to inadequate training and suboptimal update of knowledge. Recommendations: My recommendation is to promote the 60-Second Screening Tool for high-risk diabetic care and avail tool for foot neurology check whilst also improving training and development among healthcare providers (nurses) to equip them with the right knowledge on diabetic foot care and improve their attitude on diabetic foot prevention, which will increase their compliance to guidelines. There is also a need to make available material on diabetic foot care whilst also improving referral systems to avoid delay in specialist care and amputation complication.