Related Experiment Video
Updated: Feb 20, 2026

Author Spotlight: Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise
Published on: July 14, 2023
The Association between Tinea Pedis and Feet-Washing Behavior in Patients with Diabetes: A Cross-sectional Study
Kimie Takehara1, Ayumi Amemiya, Yuko Mugita
1In Tokyo, Japan, Kimie Takehara, PhD, RN, is a Lecturer, Department of Nursing Administration/Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo; Ayumi Amemiya, PhD, RN, is an Assistant Professor, Department of Nursing Physiology, Graduate School of Nursing, Chiba University; Yuko Mugita, PhD, RN, is an Assistant Professor, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo; Yuichiro Tsunemi, PhD, MD, is an Associate Professor, Department of Dermatology, Tokyo Women's Medical University; Yoko Seko, RN, is a Nurse Manager, The University of Tokyo Hospital; Yumiko Ohashi, RN, is a Ward Nurse, The University of Tokyo Hospital; Kohjiro Ueki, PhD, MD, is a Director, Diabetes Research Center, Research Institute National Center for Global Health and Medicine; Takashi Kadowaki, PhD, MD, is a Professor, Department of Metabolic Diseases, Graduate School of Medicine, The University of Tokyo; Makoto Oe, PhD, RN, is a Project Associate Professor, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo; Takashi Nagase, PhD, MD, is a Project Lecturer, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo; Mari Ikeda, PhD, RN, is a Professor, School of Nursing, Nursing Administration, Tokyo Women's Medical University; and Hiromi Sanada, PhD, WOCN, RN, is a Professor, Department of Nursing Administration/Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, Japan.
Objectives:
To examine the correlations between elements of feet-washing behavior, presence of tinea pedis (TP), and patients' background characteristics in order to identify a concrete intervention method to prevent TP.
Design And Participants:
A cross-sectional study of 30 patients with diabetes (16 with TP) who were admitted to or visited the university hospital.
Main Outcome Measures:
The presence of TP was confirmed by the detection of dermatophytes by direct microscopy. Data on elements of feet-washing behavior, such as scrubbing between the toes, were collected by observing recorded videos of participants normally washing their feet as they do at home. The patients' background characteristics included demographic data; diabetes-related factors; patient knowledge regarding diabetes, foot problems, and TP prevention; purpose for feet washing; and any difficulties in feet washing.
Main Results:
The number of times patients scrubbed between their toes while washing with soap was significantly lower in patients with TP (odds ratio, 0.95; P = .036; with a cutoff value of 35 times) and those who had difficulty in reaching their feet with their hands (B = -14.42, P = .041).
Conclusions:
An effective foot-washing protocol should include specific instructions for patients to scrub between their toes at least 35 times in all 8 spaces while washing with soap. Appropriate advice is also needed for individuals who have difficulty reaching their feet with their hands. Education about appropriate foot-washing behavior may potentially prevent TP.
More Related Videos
Related Concept Videos
Handwashing II: Pre-procedure and Initial Procedure Steps
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail...
Handwashing I: Introduction and Types of Equipment
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated....
Handwashing III: During the Procedure and Post-Procedure Steps
Hand hygiene
Hand washing...
Diabetes: Symptoms, Diagnosis, and Complications
Skin Diseases and Disorders
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...

