Self-Management Ability and Its Associated Factors in Relation to Infection Status among Patients with Diabetic Foot Ulcers: A Cross-Sectional Study

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Abstract
Abstract Background: Diabetic foot ulcer (DFU) is a major cause of infection, amputation, and disability among patients with type 2 diabetes mellitus. Wound self-management is widely recognized as an important aspect of infection prevention; however, factors associated with wound self-management and exploratory statistical pathways linking self-management ability to infection status remain incompletely understood. Methods: In this cross-sectional study, 186 patients with type 2 diabetes mellitus–related DFU were included. The Wound Self-Management Ability Scale (WSMAS), General Self-Efficacy Scale (GSES), and Social Support Rating Scale (SSRS) were administered. Multivariable logistic regression was used to identify factors associated with wound infection, receiver operating characteristic (ROC) analysis assessed discriminative performance, and mediation analysis examined whether wound self-management ability statistically accounted for the association between self-efficacy and infection status. Results: The overall level of wound self-management ability was moderate (mean 67.48 ± 10.52). Wound infection was observed in 38.7% of patients. Poor wound self-management ability was identified as an independent predictor of wound infection (adjusted OR = 2.63, 95% CI 1.61–4.32, P < 0.001), whereas higher education level and prior wound-care education were associated with a lower likelihood of infection (adjusted OR = 0.64 and 0.59, respectively). The wound self-management score demonstrated good discriminative performance in distinguishing between patients with and without wound infection (AUC = 0.79, 95% CI 0.72– 0.86). Mediation analysis suggested that wound self-management ability statistically accounted for the association between self-efficacy and infection status (β = –0.21, 95% CI –0.36 to – 0.09). Conclusions: Wound self-management ability was associated with infection status among patients with type 2 diabetes mellitus–related DFU. Education level, self-efficacy, and prior wound-care training were identified as associated factors. These findings highlight clinically relevant associations and may help inform the design of future educational or behavioral interventions to be evaluated in longitudinal or interventional studies.
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Authors Fang, Gao
Journal Frontiers in surgery
Year Year not found
DOI
10.3389/fsurg.2026.1743373
URL
https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1743373/full
Keywords Keywords not found

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