{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:47Z","timestamp":1790614247927,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,27]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot is an infection, ulceration or destruction of the tissue of the foot of a person diagnosed with diabetes mellitus (DM). Diabetic foot ulcer (DFU) is a major and preventable complication of DM. Adequate knowledge and foot self-care practices are crucial to reduce the risk of DFU complications, particularly in resource-limited healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the knowledge and practices related to foot self-care and associated factors among individuals diagnosed with diabetes attending diabetic clinics at all base hospitals in Colombo District, Sri Lanka.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      An analytical cross-sectional study was conducted among 423 individuals diagnosed with diabetes attending the diabetic clinic at all three base hospitals in Colombo district, from January 2023 to March 2024 (study period). Participants were selected by using a systematic random sampling. Data were collected using a validated and pre-tested interviewer-administered questionnaire. Descriptive and inferential analyses were performed using Statistical Packages for Social Sciences V.26 software. Associations were examined using \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests, independent sample t-tests and one-way ANOVA (Analysis of Variance), with a p value&lt;0.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of the participants were females (71.2%). Among the participants, 33.8% of them had a poor level of knowledge regarding foot self-care. Knowledge level was significantly associated with the participants\u2019 family history of diabetes and the hospital where they attended the clinic (p&lt;0.05). Females had a significantly higher mean knowledge score (60.5\u00b119.7) than males (55.4\u00b123.7) (p=0.03), and participants attending District General Hospital Avissawella had the highest mean knowledge score (67.9\u00b121.6) among other hospitals (p=0.01). Approximately 67.6% of them demonstrated satisfactory foot self-care practices. Practice level was significantly associated with the hospital where they attended the clinic and the type of medication used for DM (p&lt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly one-third of participants demonstrated poor knowledge of foot self-care, despite over half exhibiting satisfactory foot-care practices. This gap highlights the need for targeted education to boost awareness and promote consistent foot care, which is a key step in preventing diabetic foot complications and improving long-term outcomes for individuals diagnosed with diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108460","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T16:06:05Z","timestamp":1775750765000},"page":"e108460","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Foot self-care knowledge, practices and associated factors among individuals diagnosed with diabetes attending clinics at base hospitals in Colombo, Sri Lanka: an analytical cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9346-4961","authenticated-orcid":false,"given":"Buddhinie Nisansala","family":"Jayaweerage","sequence":"first","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2192-5133","authenticated-orcid":false,"given":"Manuri","family":"Hettiarachchi","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2705-6255","authenticated-orcid":false,"given":"Athukoralage Dona","family":"Kaveesha","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2527-9254","authenticated-orcid":false,"given":"Malith Ruwaranga","family":"Gamaralalalage","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6367-3280","authenticated-orcid":false,"given":"Sriskantharaja","family":"Sisudan","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9176-3754","authenticated-orcid":false,"given":"Peshila","family":"Mahanama","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0593-0221","authenticated-orcid":false,"given":"Chathuri Dilhani","family":"Malawi Arachchi","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6307-7230","authenticated-orcid":false,"given":"Thevapatham","family":"Kamshiga","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3252-0906","authenticated-orcid":false,"given":"Sandushani","family":"Kaushalya","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2026-3181","authenticated-orcid":false,"given":"Elango","family":"Shopijen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences, The Open University of Sri Lanka, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-4463","authenticated-orcid":false,"given":"Gnanaselvam","family":"Kisokanth","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, Faculty of Nursing, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"2026040909051381000_16.4.e108460.1","unstructured":"World Health Organization . 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