Year 2021
October 2021


Abstract Title
Self-efficacy and self-foot care behaviours in patients with diabetes – an observational study in Singapore



National Healthcare Group Polyclinics1 

Background & Hypothesis

Worldwide, 85% of major lower extremity amputations are preceded by foot ulcers. Self-efficacy and self-foot care behaviours reduce risk of foot ulcers. This study aimed to determine the association between self-efficacy and self-foot care behaviour among patients with diabetes, differences in self-foot care behaviour between those who attended diabetic foot screening versus those who did not, and subgroups with poorer self-foot care behaviour.


This cross-sectional study used convenience sampling to recruit 179 patients with diabetes and no bilateral above or below knee amputation from all National Healthcare Group polyclinics from January to July 2021. Self-efficacy was measured using Foot Care Confidence Scale; higher total score indicated higher self-efficacy. Self-foot care behaviour was measured using a tool with subcategories of preventive and potentially damaging behaviour; higher summed scores indicated higher levels of behaviour.


There is a weak positive correlation between self-efficacy and self-preventive foot behaviour (r=0.25,p=0.001). There are no significant differences in foot care behaviour between patients who attended diabetes foot screening versus those who did not. Significant differences between marital status and preventive behavior(F=5.09,df=2 and 175,p=0.007) and between education and self-efficacy(F=4.299,df=5 and 173,p=0.001)were observed.

Discussion & Conclusion

Patients who were divorced or had lower educational level had poorer self-foot care behaviours and lower self-efficacy hence they may benefit from individualized targeted interventions. Strategies to increase self-efficacy should be explored as self-efficacy increases positive self-foot care behaviour. This study is limited by its unequal group representation of compliant and non-compliant to diabetic foot screening and future research may consider stratified sampling approach to reduce bias.