Robling Kristyn, McPherson Kristen, Nolan Douglas, Greiner Benjamin, Hartwell Micah
Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA.
Tribal Health Affairs, Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA.
Prim Health Care Res Dev. 2025 Mar 26;26:e33. doi: 10.1017/S1463423624000392.
This study aimed to identify how frequent poor mental health days, a depressive disorder diagnosis, frequent poor physical health days, or physical inactivity affect annual foot examinations in individuals with diabetes.
Diabetes mellitus (DM), particularly type 2, is a growing problem in the United States and causes serious health complications such as cardiovascular disease, end-stage renal disease, peripheral neuropathy, foot ulcers, and amputations. There are guidelines in place for the prevention of foot ulcers in individuals with diabetes that are not often followed. Poor mental health and poor physical health often arise from DM and contribute to the development of other complications.
We performed a cross-sectional analysis of the 2021 Behavioural Risk Factor Surveillance System dataset to determine the relationship between annual foot examinations and frequent poor mental health days, a depressive disorder diagnosis, frequent poor physical health days, or physical inactivity using a bivariate logistic regression model. The regression model was controlled for age, sex, race/ethnicity, health insurance, level of education, current smoking status, and Body Mass Index (BMI) category.
Our results showed that 72.06% of individuals with frequent poor mental health days received a foot check, compared with 76.38% of those without poor mental health days - a statistically significant association (AOR: 1.25; 95% CI: 1.09-1.43). Of those reporting a sedentary lifestyle, 73.15% received a foot check, compared with 77.07% of those who were physically active, which was also statistically significant (AOR: 1.31; 95% CI: 1.14-1.49). Although individuals reporting depressive disorder diagnoses and frequent poor physical health days had lower rates of foot examinations, these results were not statistically significant. To reduce rates of foot ulcers and possible amputations, we recommend the implementation of counselling or support groups, increased mental health screening, educational materials, or exercise classes.
本研究旨在确定心理健康状况不佳的天数、抑郁症诊断、身体健康状况不佳的天数或缺乏身体活动对糖尿病患者年度足部检查的影响频率。
糖尿病，尤其是2型糖尿病，在美国是一个日益严重的问题，会导致严重的健康并发症，如心血管疾病、终末期肾病、周围神经病变、足部溃疡和截肢。目前有针对糖尿病患者预防足部溃疡的指南，但这些指南往往未得到遵循。心理健康不佳和身体健康不佳常常由糖尿病引发，并会促使其他并发症的发生。
我们对2021年行为危险因素监测系统数据集进行了横断面分析，使用二元逻辑回归模型来确定年度足部检查与心理健康状况不佳的天数、抑郁症诊断、身体健康状况不佳的天数或缺乏身体活动之间的关系。回归模型对年龄、性别、种族/族裔、健康保险、教育水平、当前吸烟状况和体重指数（BMI）类别进行了控制。
我们的结果显示，心理健康状况不佳天数频繁的个体中，72.06%接受了足部检查，而心理健康状况良好的个体中这一比例为76.38%——这是一个具有统计学意义的关联（比值比：1.25；95%置信区间：1.09 - 1.43）。在报告久坐生活方式的个体中，73.15%接受了足部检查，而身体活跃的个体中这一比例为77.07%，这同样具有统计学意义（比值比：1.31；95%置信区间：1.14 - 1.49）。尽管报告患有抑郁症诊断和身体健康状况不佳天数频繁的个体足部检查率较低，但这些结果没有统计学意义。为了降低足部溃疡和可能截肢的发生率，我们建议开展咨询或支持小组、加强心理健康筛查、提供教育材料或开设健身课程。
