ORIGINAL RESEARCH article
Front. Surg.
Sec. Vascular Surgery
This article is part of the Research TopicCurrent Understanding of Complications Associated with Diabetes - Volume IIView all 10 articles
Self-Management Ability and Its Associated Factors in Relation to Infection Status among Patients with Diabetic Foot Ulcers: A Cross-Sectional Study
Provisionally accepted
- Handan First Hospital, Handan, China
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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.
Keywords: behavioral intervention, Cross-sectional study, Diabetic foot ulcer, Education, self-efficacy, self-management, Wound Infection
Received: 10 Nov 2025; Accepted: 15 Jan 2026.
Copyright: © 2026 Hong, Weina and Fang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gao Fang
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