Chulalongkorn Medical Journal


Background : Diabetic foot care is a part of basic self-care for people withdiabetes. The Foot Care Confidence Scale (FCCS), as asubjective measure, designed to measure foot care self-beliefsof people with diabetes, was previously introduced and usedfor assessing people with diabetes’s confidence in carrying outfoot care activities. However, there is a lack of such instrumentfor use in people with diabetes. It will be useful for assessingthe confidence of foot care self-efficacy in people with diabetes.Objective : To cross-culturally adapt the Foot Care Confidence Scale intoThai and to test the reliability of Thai-FCCS and Thai foot carebehavior with questionnaires. Additionally, the relationshipbetween foot care self-efficacy and foot care behavior in Thaipeople with diabetes was investigated.Design : A cross – sectional descriptive study.Setting Bangjak Community, Samutprakarn provinceMaterials and Methods : The English FCCS questionnaire was translated with forward/backward translation process into Thai language. Meanwhile,a foot care behavior questionnaire was adapted from therecommendation of the National Diabetes Education Program(NDEP) combined with some items obtained from the Perrin’sfoot care behavior questionnaire. Thirty people with diabetes wereinterviewed with the Thai-FCCS and the foot care behaviorquestionnaire on two occasions separated by a time interval oftwo weeks for test-retest reliability. Internal consistency of thetwo questionnaires and the relationship between foot care selfefficacyand foot care behavior were tested in 373 people withdiabetes.Results : The test-retest reliability and the internal consistency ofthe Thai-FCCS were acceptable with an intraclass correlationcoefficient (ICC) of 0.733 (p <0.0001) and a Cronbach’s alphacoefficient (CA) of 0.877. The foot care behavior questionnaireshowed good test-retest reliability with an ICC of 0.808(p <0.0001), while its internal consistency was moderate with aCA of 0.667. A weak relationship between foot care self-efficacyand foot care behavior among 373 people with diabetes wasfound with Pearson product-moment correlation coefficient of0.155 (p = 0.003).Conclusion : The Thai version of the FCCS and the Thai foot care behaviorquestionnaires were reliable. Therefore, both questionnairescan be used for assessing confidence and practice of foot carein Thai people with diabetes. However, there was a weakrelationship between foot care self-efficacy and foot care behavior.


Faculty of Medicine, Chulalongkorn University

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