Factors Influencing Diabetes Foot Preventive Practices Among Patients Attending Embu and Kerugoya Level Five Hospitals, Kenya

Background: Diabetes mellitus is a growing global health concern, and foot complications remain among its most debilitating outcomes, often resulting in ulcers, infections, and amputations. Effective preventive foot care is essential, yet in many settings, adherence remains low. Understanding the underlying factors that influence foot care practices is critical to inform targeted interventions. Objective: This study explored the patient-related and healthcare-related factors influencing diabetes foot care practices among individuals living with diabetes. Methods: A qualitative, exploratory design was employed. Data were collected through focus group discussions (FGDs) with purposively selected diabetes patients attending outpatient clinics. A total of four FGDs involving 40 participants were conducted. The discussions were audio-recorded, transcribed verbatim, and analysed thematically to identify recurrent patterns and insights. Results: Two major categories of influencing factors emerged: patient-related and healthcare-related. Patient-related factors included limited knowledge of foot care, poor foot care behaviour and low self-efficacy in managing foot health. Healthcare-related factors included limited access to structured foot care education, staff shortages, and the unaffordability of health services. However, facilitators such as the availability of daily clinic services, peer support groups, and the friendliness of healthcare staff were found to positively influence patient engagement in foot care. Conclusion: The study underscores the multifaceted nature of DFC practices, highlighting the need for comprehensive interventions that address both individual and systemic barriers. Incorporating structured education, strengthening patient support systems, and improving accessibility and affordability of foot care services are essential for promoting effective preventive practices. Addressing these factors may significantly reduce the burden of diabetic foot complications and improve the quality of life for patients. Key words: Diabetes mellitus, foot care practices, diabetes foot, patient-related factors, healthcare barriers, Healthcare facilitators, structured education.