The effect of symptoms of depression on foot self-care practices and diabetes-related knowledge in housebound people with diabetes mellitus

Abstract

Aim: To investigate the effect of symptoms of depression on both foot self- care practices and diabetes related knowledge in housebound people with diabetes. Methods: A prospective quasi-experimental design was employed, and participants were recruited from the Active Aging and Community Care database and conducted at their own homes. The sample population was divided into two groups following the SRQ-20: Group 1: 55 housebound participants with diabetes and without symptoms of depression and Group 2: 62 housebound participants with diabetes and with symptoms of depression. Participants were recruited through convenience sampling by the intermediaries. The intermediaries contacted the participants by telephone and upon verbal consent to the intermediaries, the researcher conducted the house visits and recruitment. Four questionnaires were utilised: The Self- Reporting Questionnaire (SRQ-20) (To assign into the respective group), the Diabetes Knowledge Questionnaire (DKQ-24) (To assess the knowledge), Nottingham Assessment of Functional Feet (NAFF) (To assess foot care behaviour) and EQ-5D-5L Questionnaire (To assess Quality of Life). Participants were assessed at three time points over six months, with changes in diabetes knowledge, foot care behaviours, and quality of life assessed and recorded. Results: Of the 124 participants who initially agreed, 117 were included in the analysis; 7 were excluded, due to admission to long-term care (n=3) and voluntary withdrawal (n=4). Both the Kolmogorov-Smirnov and Shapiro-Wilk tests were conducted to test for normality for both the DKQ-24 and NAFF Questionnaire separately and non-parametric test were used. The mean DKQ-24 scores increased significantly over time in both groups (p < 0.001), with no significant differences between participants with and without symptoms of depression at any time point (p > 0.05), indicating similar improvements in diabetes-related knowledge. The mean NAFF scores also increased significantly over time in both groups (p < 0.001), with participants without symptoms of depression consistently scoring higher than those with symptoms at all time points (p < 0.05), reflecting better foot self-care behaviours. These findings suggest that while symptoms of depression did not affect knowledge acquisition, it was associated with lower engagement in foot self-care practices. [...]