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6 G4 / G15 /# *+ (, -. /01..2 #) 1# S\"?C7 ^ G. 45 I*$' 2; * F*".* 4C*8 1C -: B) - 54: S* NPj A) 54: S* C" S Q! S* C" NPj \$ C" - C *i. ^)' 3 4G 54: < c 54: S* 3 * CH4 C)" 3#C *i. "*N 4 C \ C" NPj?45 5 *% 54: 54: G H4.(36) 45 4C*8 N) 54: S* )*. 5* 84 :% + :)7 %*..7 C Q>" #% * 54: Q %27 :B. +( " " %51 4" =0" 98 )7*% :%.(35) 4B54" *8 :% #>B :% ; oc - CQ %*. (HBM) 54: G H4 I )+ ; )7 0)" *.?45 =0" F*" #),5 54: G H4 +) S\"?C7 )+ ; Y4E (345 Z "* QB?44:.?<Y45?)$E B) #) 1# )+ h* :% A " =A( -B c* h* Y4E.-) : Azizi F, Hatami H, Janghorbani M. Epidemiology and controlling prevalent disease in Iran. 1 st ed. Tehran: Eshtiagh Publication: 2000; 32. [Persian] 2- Falahati MM. The study of diabetes treatment research center function in Yazd province in controlling diabetes disease of its patients. [Dissertation] Shahid Sadoughi University of Medical Sciences; 2000; [Persian] 3- Mahdavi Hazaveh A, Delaveri A. Prevention and controlling program of diabetes. Health Counselor of Disease Management Center, 2004; 53. [Persian] 4- Health counseling of research and technology, the view of national health. Tehran: Tabalvor Publication: 2003; 59. [Persian] 5- Azizi F. The study of diabetes prevalence and Glucose tolerance disorder in people older than 30 years old. Research Counselor of Health Ministry, 2004; [Persian] 6- Rahimi MA. Annual Diabetic Research Center Report in Kermenshah. 2005; 23. [Persian] 7- Mehdavi HA, Norouzinegod A. Evaluation and monitoring plan of nationwide program to prevent and control diabetes disease. Health Counselor of Diseases Management Center: Tehran; 2002; [Persian] 8- Calle AL, Duran A, Calvo M. Reduction in foot ulcer incidence. Diabetes Care. 2001; 24 (4): Lanigahi B, Forouzandeh F. Diabetic foot disorders. Iran Diab Lipid Magazine 2004;2: Cuthy TH. Caring for a diabetic ulcer. Nursing 2002; 29 (21): Amini M, Khadivi R, Haghighi S. Costs of type 2 diabetes in Isfahan, Iran in Iranian J Endocrinol Metabolism. 2002; 14 (4): [Persian] 12- Fidler BD. Diabetic foot care. Drug Topics. 2002; 146 (4): Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 23 (6): Roberts SS. Foot care. Diabetes Forcast. 2005; 58 (4): Mudge E, Price P. Risk of diabetic foot ulceration: perception and behavioral change Available from: URL: m0 MDQ/is

7 () # % "& '... #!"# 16- Aguiar ME, Burrows NR, Wang J. History of foot ulcer among persons with diabetes-united States MMWR. Morbidity and Mortality Weekly Report 2003;52 (5): Ranjbar Omrani Gh.H, Soveid M, Rajaei H, Sadegholvaad AS. The incidence of chronic diabetic complications during a 12 years period in patients referring to clinics of Shiraz University of Medical Sciences. Iranian J Diabetes Lipid Disorders. 2004; 2 (3): [Persian] 18- Larigani B, Bastane hagh MH, Pjouhi M, Afshari M,Ghani M, Shagarian M.A survey about the prevalence of amputation in diabetic patients with diabetic foot that were confined to bed in the shariaty and emam khomaini hospitals from Iranian J Diabetes Lipid. 2001; 1: [Persian] 19- Valente LA, Caughy M, Fischbach L. A validation study of a self-adminstered questionnaire to identify increased risk for foot ulceration or amputation among people with diabetes. The Diabetes Educator 2004;30 (3): US Department of Health and Human Services: Healty people nd ed. Washington, DC, U.S.Dept. of Health and Human Services, 2000: Ghanadei F. (Translating in Farsi). Diabetes mellitus disease (guidance and education of patients). In: Metez P, Benson J. 1 st ed. Isfahan: Kankash Publisher; [Persian] 22- Afkhami Ardakani M, Yadolahi A, Abolhasani A. Knowledge rate of people in Azadshahr Yazd about diabetes disease. J Med Univ Yazd. 2000; 4: [Persian] 23- Moghadam TF, Mohadesi H, Bahaei H. The study of education needs of diabetic patients about self-care in referents to clinic for especial diseases in Taleghani Hospital. The Second National General Health and Preventive Medicine [Persian] 24- Javadi A, Javadi M, Sarvghadi F. The study of knowledge, attitude and practice of diabetics to their illness. J Birjand Univ Med Sci. 2004; 20 (11): [Persian] 25-Batista F, Pinzur MS. Disease knowledge in patients attending a diabetic foot clinic. Foot Ankle Int. 2005; 26 (3): Beranth c. The health belief model applied to glycemic control. The Diabetes Educator. 1999; 21(8): Tan MY. The relationship of health belief and complication prevention behaviors of Chinese in individual with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2004; 66 (4): Graziani C, Rosenth LP, Diamond JJ. Diabetes education program use and patient-perceived barriers to attendance. Family Medicine. 1999; 31 (8): Najarian R, Brunchaud C, Gohdes D. Reducing lower extremity amputations due to diabetes: application of the staged diabetes management approach in a primary care setting. J Fam Pract. 1998; 47 (12): Vickie R, Madsen J, Goodman RA. Reducing amputation rates in patient with diabetes at a military medical center. Diabetic care 2005; 28 (3): Robinson S, Bodenheimer C. Health practices of veterans with unilateral lower-limb loss: Identifying correlates. JRRD. 2004; 41(10): Daniel M, Messer LC. Perceptions of disease severity and barriers to self-care predict glycemic control in aboriginal persons with type 2 diabetes mellitus Available from: URL: 33- Polly RK. Diabetes health self-care behaviors and glycemic control among older adults with non-insulin-dependent diabetes mellitus. Diabetes Educ. 1997; 18 (2): Aljasem LI, Peyrot M, Wissow L, Rubin RR. The impact of barrier and self-efficacy on self-care behavior in type 2 diabetes. Diabetes Educ. 2001; 27 (6): Jafarian N, Heidari AA. Self-care programs of non insulin dependent diabetic patients referring to the Hamadan Diabetic Research Center. Shadid Sadoughi Univ Med Sci J. 2002; 3: [Persian] 36- Allahverdipour H. Passing through traditional health education moving to based theory. Health Education and Health Promotion Magazine 2004; 1: [Persian] 90

8 G4 / G15 /# *+ (, -. /01..2 Title: Survey of the feet care based on Health Belief Model in diabetes type II patients referring to the Diabetes research center of Kermanshah in 2006 Authors: Gh. Sharifirad 1, S. Mohebbi 2, M. Matlabi 3 Abstract Background and Aim: Diabetic foot complication and its amputation is one of the most physical and emotional disabilities in diabetic patients. Since much of the care of the patients is on their own part and it is not possible for them to be under the medical attention of physicians, nurses and health workers, the best way is to care for their feet at home. The aim of this study was to survey the care of the feet based on Health Belief Model in type II diabetics referring to Kermanshah diabetes research center. Materials and Methods: In this cross-sectional study 108 type II diabetic patients referring to Kermanshah diabetes center were selected randomly. Data collecting was done by means of a questionnaire having 59 questions and covering, 5 sections including: demography, knowledge, health belief model (perceived susceptibility, severity, benefits, barriers, and cues of action) foot care at home, and the checklist. Results: The findings showed that 33.3% of the subjects got only 40% of knowledge scores and 14.8% had not acquired at least 30% of the scores. The patients' perceived susceptibility was low, so that 32.4% of them were not aware of the risk of diabetic foot and only 2.8% of them knew foot-care benefits completely. The findings showed that there was a significant relationship between the mean score of perceived benefits scores and the level of perceived susceptibility with the level of foot care (P< 0.05); because only 2.8% of the patients took everyday necessary care of their feet at home. Conclusion: According to this study knowledge and attitude of the subjects (i.e. two aspects of Health Belief Model) were at an average level but their behavior regarding foot care was lower than average. It seems that the use of theoretical based models such as Health Belief Model and self-efficacy theory can be effective on promoting foot care level. Key Words: Diabetic foot; Health Belief Model; Foot care 1 Associate Professor, Faculty of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. 2 Corresponding Author; Instructor, Gonabad University of Medical Sciences, Gonabad, Iran. mohebisiamak@yahoo.com 3 Instructor, Gonabad University of Medical Sciences, Gonabad, Iran. 91