Perceived risk of amputation, emotions, and foot self-care among adults with type 2 diabetes

Purpose The purpose of this study was to determine the influence of having a family member who experienced an amputation on one's own perceived risk and fear of experiencing a diabetes-related amputation. Methods This was a descriptive cross-sectional study using paper-and-pencil surveys by mail. Adults with type 2 diabetes and a family history of diabetes attending a self-management education program in the Metropolitan New York/ New Jersey area were recruited. Measures were completed about risk perception and fear of amputation, emotional representations of diabetes from the Illness Perception Questionnaire, and the foot self-care behavior component of the Summary of Diabetes Self-care Activities Survey. The authors estimated the variability in foot self-care that was accounted for by risk perception and fearful memories. Results In those who remembered a family member needing an amputation, high perceived risk and fear was associated with less routine foot self-care. For those without family history of amputation, fear was positively associated with foot self-care. Conclusions Motivation for foot self-care behavior may be driven by risk perception and emotional responses. The ways in which risk perception and fear influence motivation for preventive foot self-care behavior are influenced by whether one's family member was affected by an amputation. Probing about the influence of the patient's legacy of diabetes may be helpful when customizing education plans.