Screening behaviors for diabetic foot and their influencing factors among general practitioners: a cross-sectional study in Changsha, China

Abstract

Abstract Background Diabetic foot is a serious complication of diabetes with a high disability and mortality rate, which can be prevented by early screening. General practitioners play an essential role in diabetic foot screening, yet the screening behaviors of general practitioners have rarely been studied in primary care settings. This study aimed to investigate foot risk screening behaviors and analyze their influencing factors among general practitioners. Methods Using the convenience sampling method, a cross-sectional study was conducted among 844 general practitioners from 78 community health centers in Changsha, China. A self-designed and validated questionnaire was used to assess the general practitioner’s cognition, attitude, and behaviors on performing diabetic foot screening. Multivariate linear regression was conducted to investigate the influencing factors of screening behaviors. Results The average score of diabetic foot screening behaviors among the general practitioners was 61.53 ± 14.69, and 271 (32.1%) always or frequently performed foot screening for diabetic patients. Higher training frequency (β = 3.197, p < 0.001), higher screening cognition (β = 2.947, p < 0.001), and more positive screening attitude (β = 4.564, p < 0.001) were associated with more diabetic foot screening behaviors, while limited time and energy (β=-5.184, p < 0.001) and lack of screening tools (β=-6.226, p < 0.001) were associated with fewer diabetic foot screening behaviors. Conclusion The score of screening behaviors for the diabetic foot of general practitioners in Changsha was at a medium level. General practitioners’ diabetic foot screening behaviors may be improved through strengthening training on relevant guidelines and evidence-based screening techniques, improving cognition and attitude towards foot screening among general practitioners, provision of more general practitioners or nurse practitioners, and user-friendly screening tools.