INTRODUCTION: One of the most important and debilitating complication of diabetes mellitus is foot
problem such as ulcers, infections and amputations. However, these complications are preventable by simple
intervention such as regular foot care practice. This study aims to assess the foot care practice and its
associated factors among type 2 diabetes mellitus patients attending primary health clinics in Kuantan.
MATERIALS AND METHODS: This was a cross-sectional study conducted at four primary health clinics in
Kuantan involving 450 study participants who were selected by using universal sampling method. Level of
awareness and practice toward diabetic foot care was assessed using validated self-administered
questionnaire. Multiple logistic regressions were performed to identify factors associated with poor foot care
practice among the respondents. RESULTS: About 59.6% of respondents had poor foot care practice and
50.9% had poor awareness level. Multivariate logistic regression analysis identified that, increasing age
(OR 0.97, 95% CI: 0.955-0.993) and good awareness towards foot problem (OR 0.43, 95%CI: 0.289-0.643)
were less likely to have poor foot care practice. However, Malay ethnicity (OR 1.81, 95% CI: 1.002-3.271) and
obesity (OR 1.9, 95% CI: 1.225-2.976) were associated with poor foot care practice after controlling other
variables. CONCLUSION: Majority of the respondents had poor foot care practice and poor awareness.
Respondents who are older and have better awareness are less likely to have poor foot care practice.
Diabetic patients who are Malays and/or obese are predicted to have poor diabetic foot practice and hence
must be prioritized for a sustainable patient education and compliance towards foot care practice at primary
care level.
Intimate partner violence (IPV) during the first year postpartum is common in Bangladesh, and many infants are exposed to hostile and aggressive environment. The aim of the current study was to investigate how IPV (physical, emotional, and sexual) impacts on the mother's perception of her infant's temperament 6 to 8 months postpartum, and whether maternal depressive symptom at 6 to 8 months postpartum is a mediator in this association. A total of 656 rural Bangladeshi women and their children 6 to 8 months postpartum were included in this study. Data were collected by structured interviews. The women were asked about physical, sexual, and emotional IPV; depressive symptoms (Edinburgh Postnatal Depressive Symptoms [EPDS]); and their perception of infant temperament assessed by the Infant Characteristic Questionnaire (ICQ). Descriptive analyses were conducted for prevalence of IPV and maternal depressive symptoms. Mediation analysis was conducted with a series of linear regressions with types of IPV as independent variables, ICQ including its subscales as dependent variables and maternal depressive symptoms as potential mediator. All the analyses were adjusted for the woman's and her husband's ages and number of children of the couple. Nearly 90% of the mothers reported some kind of IPV at 6 to 8 months postpartum. All types of IPV were directly associated with the mother's perception of her infant as unadaptable. Maternal depressive symptom was a mediating factor between physical IPV and the ICQ subscales fussy-difficult and unpredictable. In addition, depressive symptoms mediated between sexual and emotional IPV, and the mother's perception of the infant as unpredictable. The results showed that IPV influenced how mothers perceived their infant's temperament. It is important that health care professionals at maternal and child health services enquire about IPV with possibilities to refer the family or the mother and infant for appropriate support.