Abstract:

Objective To analyze the potential categories of foot care knowledge-attitude-practice（KAP） of diabetic high-risk foot patients，and analyze the influencing factors of different potential categories classification prediction，so as to provide references for clinical nursing. Methods By convenience sampling，a questionnaire survey was conducted from July to December 2023，employing a general information questionnaire and a diabetes foot care KAP evaluation scale on patients at high risk of diabetic foot in a tertiary hospital in Guangzhou. Latent profile analysis was used to identify the potential classifications of foot care KAP status among these patients. The iterative dichotomiser 3 algorithm of decision tree in machine learning was used to make classification prediction of foot nursing KAP status of patients，using multivariate logistic regression to analyse its influencing factors. Results There are 3 potential profiles of foot care KAP in high-risk diabetic foot patients，including “high knowledge-medium attitude-medium behavior” type（29.00%），“low knowledge-low attitude-low behavior” type（56.00%） and “medium knowledge-high attitude-high practice” type（15.00%）. Decision tree model showed that residence，education level，receiving education about diabetic foot and stage of diabetic high-risk foot were decision-making factors for different potential categories of foot care KAP. The results of the Logistic analysis showed that literacy level, per capita monthly household income, and whether received diabetes-related follow-up were influential factors in different potential profiles of foot care KAP. Conclusion The level of foot care KAP of patients at high risk of diabetic foot needs to be improved，and shows population heterogeneity. Medical staff should intervene and support diabetic foot patients at high risk according to different potential profile and influencing factors to improve their KAP level.

Key words: Diabetic Foot, Nursing Care, Knowledge, Attitude, Practice, Latent Profile Analysis, Decision Tree Analysis

摘要：

目的 分析糖尿病高危足患者足部护理知识、态度、行为（以下简称知信行）的潜在剖面，分析不同潜在剖面分型预测的决策和影响因素，为临床护理提供参考。 方法 采用便利抽样法，选取2023年7月—10月在广州市某三级甲等医院就诊的200例糖尿病高危足患者作为调查对象，采用一般资料调查表、糖尿病患者足部护理知识、态度和行为评价量表进行调查。通过潜在剖面分析确定糖尿病高危足患者足部护理知信行的潜在类别，采用机器学习中迭代二叉树3代算法对患者足部护理知信行不同潜在剖面进行分型预测，采用多因素Logistic回归分析其影响因素。 结果 糖尿病高危足患者足部护理知信行存在3个潜在剖面：高知识-中态度-中行为型（29.00%）、低知识-低态度-低行为型（56.00%）和中知识-高态度-高行为型（15.00%）。决策树模型显示，居住地、文化程度、是否接受过糖尿病足相关健康教育以及糖尿病高危足分期是足部护理知信行不同潜在剖面的决策因素。多因素分析结果显示，文化程度、家庭人均月收入、是否接受过糖尿病相关随访是足部护理知信行不同潜在剖面的影响因素。 结论 糖尿病高危足患者的足部护理知信行水平有待提升，且存在群体异质性。医护人员应根据不同潜在剖面及影响因素对糖尿病高危足患者进行干预，以提高其知信行水平。

关键词: 糖尿病足, 护理, 知识, 态度, 行为, 潜在剖面分析, 决策树分析