The devil is in the detail: Prevention of diabetic foot ulceration in rural area is possible

Background: Foot self-care capability is an important factor in diabetic foot ulceration, especially in disadvantaged rural areas. Aim: To explore the causes of foot ulceration and practice foot self-care behaviors before and after diabetic foot ulceration. Method: A descriptive, retrospective design was conducted in a rural hospital in southern Taiwan. Results: A total of 49 participants with diabetic foot ulcers participated in this study. More than half were male (63.3%), still working in farming or fishing (61.2%). All participants were suffering from peripheral neuropathy (100%) and 71.5% showed claudication. Nearly two thirds reported not having received diabetic foot care education and 82% not having received regular vasculopathy assessment before the wound appeared. The common reasons for foot ulcers were unnoticed trauma, neglect of foot self-care. Conclusions: Most diabetic foot ulcers are preventable, since they result from a high prevalence of peripheral neuropathy, inadequate provision of vasculopathy assessment and inappropriate management of foot self-care. Community health nurses can focus care toward screen regularly for early diabetic foot problems.