Medical Doctors, Nurses, and Therapeutic Health Practitioners Knowledge of Risk Factors and Prevention of Diabetic Foot Ulcer: A Cross-Sectional Survey in a South African Setting

Background/Objective: Prevention of foot ulceration is critical to reduce the amputation rate in individuals with diabetes mellitus (DM). We investigated the knowledge of diabetic foot care management and prevention of diabetic foot ulcer (DFU) among categories of healthcare practitioners (HCPs). Methods: This descriptive cross-sectional observational study was conducted at public healthcare facilities within the Charlotte Maxeke Johannesburg Academic Hospital Cluster in Gauteng, South Africa. Participants included podiatrists, physiotherapists, occupational therapists, dieticians, medical orthotists and prosthetists, nurses, and medical doctors. Data were collected using a self-administered questionnaire that assessed knowledge of DFU risk factors, foot examination, foot care, and appropriate footwear. Knowledge level was classified as extremely poor if less than 50% of participants from a category of HCPs answered appropriately, reasonable for 50–59%, average at 60–69%, above average from 70–79%, and excellent when ≥80%. The questionnaire was completed by 449 HCPs and analyzed using STATA version 15, with statistical significance set at a p-value less than 0.05. Results: A total of 449 HCPs participated, which comprised the following: 48.1% (216) therapeutic health practitioners (THPs), 37.4% (168) nurses, and 14.5% (65) medical doctors. Only 36% (162) of participants had prior education on DFU. The overall knowledge levels among participants were risk factors of DFU (80%), foot examination (80%), identification of limb-threatening conditions (82%), foot care (77%), and footwear (65%). Medical doctors had the highest median scores for risk factors (85) and foot examination (80), followed by nurses (80 for risk factors and 78 for foot examination). THPs had the lowest median scores for risk factors (78) and foot examinations (70). Differences in knowledge levels across HCPs were statistically significant (p < 0.05). Conclusions: THPs have insufficient knowledge of diabetic foot care and prevention of DFUs. Comprehensive training and targeted educational programs are needed to fill these gaps and improve patient care.