Nurses' knowledge on diabetic foot ulcer disease and their attitudes towards patients affected: A cross-sectional institution-based study

Abstract

Aims and objectives: To assess nurses' knowledge on diabetic ulcer disease and their attitudes towards patients suffering from it and to identify factors which influence them.

Background: Diabetic wound care is an evolving specialty with the rising prevalence of diabetes foot complications. As nurses play a key role in wound care, their knowledge and attitudes are important in providing optimum care to patients.

Design: Descriptive cross-sectional survey design.

Methods: The study was conducted in three teaching hospitals. Data were collected using a pretested, validated, self-administered questionnaire from purposively recruited, voluntarily participating nurses (n = 200) who were in diabetic wound care practice for ≥1 year.

Results: Lack of formal wound care training was reported by 91.2%. Mean knowledge score was 77.9 (range 53.3-100 on a scale from 0-100) with 57.8% of nurses obtaining ≥80%. Nurses demonstrated an overall positive attitude towards caring for diabetic ulcer patients (median = 41, range 23-50 on a scale from 10-50). However, the study identified deficits in core knowledge and some negative attitudes such as insensitivity to pain. Statistically significant associations were seen between nurses' knowledge and duration of nursing, wound care experience and the type of unit they are attached to. In-service education (77.2%) and knowledge sharing with peers (77.9%) were the most popular knowledge-updating sources. Although 98.6% of nurses were interested in wound care, only 8.3% wished to engage in research. No correlation was observed between nurses' knowledge and attitudes.

Conclusion: Gaps in core knowledge and negative attitudes may be attributed to inadequate training, suboptimal update of knowledge and lack of interest in wound care research.

Relevance to clinical practice: Wound care training should be made mandatory to improve quality of care given by nurses to patients with diabetic ulcers. Continuous professional development, evidence-based practices and wound care research should be encouraged.

Keywords: attitudes; diabetic leg and foot ulcers; knowledge; nurses; wound care.