Cross-cultural adaptation of the foot care confidence scale into Thai and relationship between the foot care confidence scale and foot care behavior in people with diabetes

Abstract

Background : Diabetic foot care is a part of basic self-care for people with diabetes. The Foot Care Confidence Scale (FCCS), as a subjective measure, designed to measure foot care self-beliefs of people with diabetes, was previously introduced and used for assessing people with diabetes’s confidence in carrying out foot care activities. However, there is a lack of such instrument for use in people with diabetes. It will be useful for assessing the confidence of foot care self-efficacy in people with diabetes.

Objective : To cross-culturally adapt the Foot Care Confidence Scale into Thai and to test the reliability of Thai-FCCS and Thai foot care behavior with questionnaires. Additionally, the relationship between foot care self-efficacy and foot care behavior in Thai people with diabetes was investigated.

Design : A cross – sectional descriptive study.

Setting : Bangjak Community, Samutprakarn province

Materials 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 the recommendation of the National Diabetes Education Program (NDEP) combined with some items obtained from the Perrin’s foot care behavior questionnaire. Thirty people with diabetes were interviewed with the Thai-FCCS and the foot care behavior questionnaire on two occasions separated by a time interval of two weeks for test-retest reliability. Internal consistency of the two questionnaires and the relationship between foot care selfefficacy and foot care behavior were tested in 373 people with diabetes.

Results : The test-retest reliability and the internal consistency of the Thai-FCCS were acceptable with an intraclass correlation coefficient (ICC) of 0.733 (p <0.0001) and a Cronbach’s alpha coefficient (CA) of 0.877. The foot care behavior questionnaire showed good test-retest reliability with an ICC of 0.808 (p <0.0001), while its internal consistency was moderate with a CA of 0.667. A weak relationship between foot care self-efficacy and foot care behavior among 373 people with diabetes was found with Pearson product-moment correlation coefficient of 0.155 (p = 0.003).

Conclusion : The Thai version of the FCCS and the Thai foot care behavior questionnaires were reliable. Therefore, both questionnaires can be used for assessing confidence and practice of foot care in Thai people with diabetes. However, there was a weak relationship between foot care self-efficacy and foot care behavior.