CHAPTER 1

Background of the Study

Diabetes is said to be the “mother” of all disease and it is one of the major causes

of mortality worldwide (Abdullah, Senany, & Al-otheimin, 2017) this affects both quality of

life and quality of care among people living with diabetes including their families, and their

surrounding community. In the Philippines, the 9-year incidence rate of type 2 diabetes

was around 16.3% and it is continuously increasing in trend (Tan, 2016). The Department

of Health (DOH) in the Philippines created several programs in order to landscape the

trend of diabetes in the Philippines. Provision of free anti-diabetes medications,

participation in the World Diabetes Day Celebration, health lectures, screening for

diabetes, and health promotion through Zumba exercise are some of the examples how

the DOH spearheads nationwide efforts to prevent diabetes and its complications (DOH

Leads World Diabetes Observance In The Philippines, 2017).

Looking at Diabetes’ burden of disease, it is exceptionally high especially in terms of

economic cost and its secondary effects to human particularly to diabetes related

illnesses. The patient experiences burden related to diabetes but also their family and

community (Chadwick, 2013). The rise in the prevalence of Diabetes, foot complications

of diabetes also rises particularly diabetic foot ulcer. Uncontrolled diabetes also leads to

other serious complications namely: stroke, heart attack, and end-stage kidney disease

(DOH Leads World Diabetes Observance In The Philippines, 2017). The presence of
such complications further increases the burden of a diabetic patient thus the need for

early prevention and treatment of diabetes complications.

Nurses plays an important role in health promotion and prevention from further

complication of diabetes such as diabetic foot ulcers (Kumarasinghe, 2017). One of the

strengths of nursing care practice is health promotion (Raingruber, 2012). Early diabetes

prevention through screening and health education and other health programs are done

by multidisciplinary approach because of its long term management. The team is

composed of a physician, nurse, educator, and podiatrist to name a few (Kaya & Karaca,

2018). Aside from the other health care team members, it was noted that Nurses and

Podiatrist are often the primary source of information of patients with diabetic foot disease

(M. Aalaa, 2012).

Insufficient knowledge, approach to foot care, patient education, and patient motivation

plays a significant contribution in the causation of foot problems (Kaya & Karaca, 2018).

Hence, understanding the complications, risk factors, and how the nurse will attend to

patient’s needs will lead to better outcomes and provision of optimum patient care

services as nurses are regarded as the primary point of contact of patients.

Statement of the Problem

The study aimed to determine the level knowledge and attitudes of nurses towards

patients with diabetic foot disease in Urdaneta city. Specifically, it pursued to answer the

following questions. Specifically, it pursued to answer the following questions:

1. What is the profile of the respondents in terms of:

a. age;

b. gender;

c. civil status;

d. religion;

e. educational attainment;

f. length of practice in the nursing profession;

g. employment category;

h. frequency of exposure to continuing medical education activities

2. What is the respondent’s knowledge towards patients with diabetic foot ulcers

3. What is the respondent’s attitudes towards patients with diabetic foot ulcers

3. Is there a significant difference between the respondent’s profile variables and their

knowledge towards patients with diabetic foot ulcers?

4. Is there a significant difference between the respondent’s profile variables and their

attitudes towards patients with diabetic foot ulcers?

Research Hypothesis

The hypothesis was tested in its null form at 0.05 level of significance stating that there is

a significant difference on the respondent’s knowledge and attitudes towards patients with

diabetic foot ulcers across their profile variables.

Significance of the Study

The researchers believed that the results of the study will be a great advantage to

the following:
 Respondents. This study is essential to inform nurses of the need for further

training or sustaining their knowledge about diabetes foot ulcer. This will also benchmark

on how they will approach their patients and this will guide them in identifying what

aspects of their patient care that needs improvement.

Patients with diabetic foot ulcer. Providing patients with the optimum quality

patient care will enhance patient satisfaction, compliance to treatment regimen, improved

wound healing time, better control of their disease, and empowerment of their

psychosocial life domain.

Barangay Health Workers. As partners of care, this study will enable them to

formulate programs that will serve as a link between patients with diabetic foot ulcers and

nurses who can help them further towards health promotion, disease prevention, and

health maintenance.

Community Leaders. Tapping the community leaders and coordinating with them

successfully will enhance the participation of patients in the community health care

programs rendered by the health care team. This study will further support that nurses

are competent and reliable in providing quality care to their patients.

Nursing Leaders. The result of the study will serve as a basis on what aspects to

improve or maintain. This will also encourage them to create more programs for nurses

to enhance their skills in handling patients with diabetic foot ulcers/

Future Researchers. The result of the study will be their bases for a wider scope

of research in a bigger population.

Scope and Delimitation of the Study

This study aims to determine the level of knowledge and attitudes of nurses

towards patients with diabetic foot ulcers in Urdaneta City. The study will focus on nurses

who handles direct patient care and who are employed either permanent, temporary, or

contractual.

Definition of Terms

For better clarity and understanding of this study, the following terms has been

operationally defined.

Burden of Disease. It is the impact of a health problem as measured by financial

cost, mortality, morbidity, or other indicators

Continuing Medical Education. In this study, this also refers to “Continuing

Professional Development”. This is a type of activity wherein the objectives of the program

is to enhance the knowledge, skills, and attitude of its participants. It aims to update the

professionals in the latest trend and research findings in their respective profession.

Department of Health (DOH). In this study, it is public health government agency

that actively promotes prevention and control of diabetes and its complications.

Diabetes. It is a chronic disease characterized by elevated levels of blood sugar

(hyperglycemia) because of insufficient production and/or action of insulin.

Diabetic Foot Ulcer. In this study, it is one of the complications of Diabetes where

in there is an open sore or non-healing wound located at patient’s foot. This is typical

among diabetic patients whose blood sugar indices are uncontrolled.

 Employment Category. In this study, this includes permanent, temporary, and

contractual.

Insulin. It is the hormone responsible for the regulation of blood sugar levels.
Bibliography
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Chadwick, P. E. (2013). Best Practice Guidlines: Wound Management in Diabetic Foot Ulcers. Retrieved
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DOH Leads World Diabetes Observance In The Philippines. (2017). Retrieved from
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Kaya, Z., & Karaca, A. (2018). Evaluation of Nurses’ Knowledge Levels of Diabetic Foot Care
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Kumarasinghe, S. A. (2017). Nurses’ knowledge on diabetic foot ulcer disease and their attitudes
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M. Aalaa, O. T.-T. (2012). Nurses’ role in diabetic foot prevention and care; a review. Journal of Diabetes
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Raingruber, B. (2012). Health Education, Health Promotion, and Health: What Do These Definitions Have
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