Vol. 3, Issue 10, Part E (2017)

Abstract
A useful instrument for the prediction of foot ulcer requires a highly sensitive with specificity, good predictive value and easy to use in the clinical practice. Objective of the study was to develop and validate foot ulcer risk assessment tool for diabetic patients. A methodological study was conducted on diabetic patients without foot ulcer and with foot ulcer attending O.P.D or admitted in selected hospital of Haryana (n=100). From related review of literature, experts' guidance and investigators' personal experience, a list of risk factors were identified. These identified risk factors were compared with standardized risk assessment scales i.e. Chinese version of the diabetes self-care scale (C-DSCS), the foot care subscale of the summary of diabetes self-care activity questionnaire (SDSCA) and Diabetes foot self-care behavior scale. The final draft of tool consists 22 items. Overall cronbach’s alpha coefficient of present tool was 0.83 signifying that tool was having a good internal consistency. Test-retest reliability was 0.68 which indicates the stability of tool. Content and face validity was done by the opinion of experts. The content validity index calculated which was 0.80 signifying that tool was having a good content validity. For construct validity of the tool, known group technique was used. There was a statistically significant difference between the scores of diabetic patients without foot ulcer and with foot ulcers. It signifies that tool was having good construct validity. The range of rating score was 27 to 75, with the assumption that higher the scores, the greater the risk of foot ulcer development. At a cutoff point of ≥42, the best balance between the sensitivity and specificity was achieved, i.e. sensitivity was 86%, specificity 84%, Positive predictive value 84% and negative predictive value was 85%. The cut-off point of the tool was ≥42, patients who are having a score ≥42, are at risk for development of foot ulcer. The finding of the study revealed that foot ulcer risk assessment tool was good reliability and validity. It can be used in prediction of foot ulcer in diabetic patients.