Constant foot care is often required for patients with diabetes. Unfortunately, people with diabetes and peripheral neuropathy often do not implement the foot-care behavioral strategies that are suggested by many health professionals. The concept of self-efficacy has been shown to be an effective predictor of behavior in many areas of health. Perrin and colleagues investigated the relationships between foot-care self-efficacy beliefs, self-reported foot-care behavior, and history of diabetes-related foot pathology in people with diabetes and loss of protective sensation in their feet. Ninety-six participants were included in the cross sectional study undertaken in a regional city of Australia. All participants had diabetes and clinically diagnosed loss of protective sensation in their feet. The participants completed a self-report pen-paper questionnaire regarding foot-care self-efficacy beliefs (the "Foot Care Confidence Scale"), and two aspects of actual foot-care behavior- preventative behavior and potentially damaging behavior. Pearson correlation coefficients were then calculated to determine the association between foot-care self-efficacy beliefs and actual reported foot-care behavior. Multiple analyses of variance was undertaken to compare mean self-efficacy and behavior subscale scores for those with a history of foot pathology, and those that did not. A small positive correlation was found between self-efficacy beliefs and preventative behavior. There was no association between self-efficacy beliefs and potentially damaging behavior. There also was no difference in self-efficacy beliefs in people that had a history of foot pathology compared to those that did not.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that there was little association between foot-care self-efficacy beliefs and actual foot-care behavior. The usefulness of measuring foot-care self-efficacy beliefs to assess actual self foot-care behavior using currently available instruments is limited in people with diabetes and loss of protective sensation.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Although the association between foot-care behaviors and self-efficacy were limited, other variables could have been influential. First, the patients may not have been taught the most appropriate self-management skills to use in performing foot-care. The study suggests further research is needed in this area by investigators such as Perrin and coworkers. Second, self-efficacy often emerges only after patients have performed self-care behaviors over a period of time and across settings. The strength of self-efficacy could have increased had the study been conducted over a longer period of time (although no differences were found with respect to degree of experience in this study).

BM Perrin et al. The association between foot-care self efficacy beliefs and actual foot-care behavior in people with peripheral neuropathy: a cross-sectional study. Journal of Foot & Ankle Research, 2009;2:3.