Knowledge, Attitudes and Foot Care Practices Among Patients with Diabetic Foot Infection Attending a Rural Tertiary Care Hospital in Kerala: An Analytical Cross-Sectional Study

Background: Diabetic foot infection (DFI) is a common and serious complication of diabetes mellitus and is a leading cause of hospitalisation, disability, and lower limb amputation. Knowledge, attitude, and practice (KAP) regarding foot care play a crucial role in preventing diabetic foot complications. The aim is to assess the knowledge, attitudes, and practices regarding diabetic foot infection and identify factors associated with poor foot care practices among patients attending a rural tertiary care hospital in Kerala.Material and Methods: An analytical cross-sectional study was conducted among 100 patients with diabetic foot infection. Data were collected using a validated, semi-structured questionnaire that assessed socio-demographic characteristics and KAP regarding diabetic foot care. Composite KAP scores were calculated. The participants who scored less than 50% of the total knowledge score were considered to have poor knowledge, whereas those who scored 50% or more were considered to have good knowledge. The chi-square test and binary logistic regression were performed with SPSS. p-value <0.05 was considered statistically significant.Results: Among the participants, 69.0% were males and 56.0% were aged above 60 years. Diabetic foot ulcer was present in 42.0% of patients, and the duration of diabetes was more than 30 years in 21.0%. Regarding knowledge and attitudes, 57.0% of respondents believed that diabetic foot ulcers are not preventable, 50.0% were unaware of the need for protective footwear, and 87.0% acknowledged the importance of physical activity. Poor foot care practices were incorrect toenail trimming (82.0%), dry dressings (81.0%), not drying the feet after washing (75.0%), wearing unfastened slippers (70.0%) and not inspecting feet regularly (67.0%). Poor foot care practices were significantly associated with deficient knowledge (p=0.003).  Multivariate analysis identified deficient knowledge as the only independent predictor of poor practices (AOR = 2.30; 95% CI: 1.20–4.40; p = 0.012). Conclusion: Deficient knowledge significantly contributes to poor foot care practices among patients with diabetic foot infection. Targeted educational and behavioural interventions are essential for improving foot care practices and reducing diabetic foot complications.

Keywords: Diabetic Foot Infection; Diabetes Mellitus; Knowledge; Attitude; Practice; Foot Care; Rural Population; Kerala; Diabetic Foot Ulcer; Health Education.