Background: Although recent systematic reviews indicate low adherence to foot care practices among patients with type 2 diabetes compared to other self-management behaviors, smart healthcare technologies offer potential solutions for improving foot care management. The smart diabetic foot screening system represents an innovative approach to diabetic foot care. However, the factors influencing its adoption, particularly the relationship between knowledge, behavior, and technology acceptance, remain poorly understood.

Methods: A mixed-methods design was employed, integrating quantitative and qualitative data. Quantitative data were collected from 80 patients with type 2 diabetes using validated instruments: the foot care knowledge questionnaire, diabetic foot self-management behavior scale, and the unified theory of acceptance and use of technology questionnaire. Pearson correlation and regression analyses examined relationships between knowledge, behavior, and technology adoption intention. In-depth, semistructured interviews with 20 participants explored adoption factors. Thematic analysis was conducted on qualitative data.

Results: Despite high levels of foot care knowledge (86.2% correct response rate), actual self-management behaviors remained suboptimal, with a modest correlation between knowledge and behavior (r = 0.31 and p < 0.01). Regression analysis identified attitude and facilitating conditions as significant predictors of smart system adoption intention, explaining 57% of the variance. Qualitative analysis revealed three main themes: technology acceptance perceptions, implementation support system, and self-management patterns, highlighting the complex interplay between knowledge, attitudes, and behavioral factors.

Conclusions: This study reveals that despite improved knowledge levels compared to previous decades, the knowledge-behavior gap in diabetic foot care persists. The findings suggest that successful implementations of smart healthcare technologies require addressing both attitudinal factors and facilitating conditions, rather than focusing solely on knowledge enhancement. These insights contribute to understanding technology adoption in chronic disease self-management and inform the development of more effective implementation strategies.

Keywords: diabetic foot care; health knowledge; mixed‐methods research; self‐management behavior; smart healthcare technology; technology adoption; type 2 diabetes.

© 2025 The Author(s). Journal of Foot and Ankle Research published by John Wiley & Sons Australia, Ltd on behalf of Australian Podiatry Association and The Royal College of Podiatry.

背景： 尽管最近的系统综述表明，与其它自我管理行为相比，2型糖尿病患者对足部护理实践的依从性较低，但智能健康技术为改善足部护理管理提供了潜在解决方案。智能糖尿病足筛查系统代表了糖尿病足护理的一个创新方法。然而，影响其采用的因素，特别是知识、行为和技术接受度之间的关系仍然不够清楚。

方法： 采用了混合研究设计，整合定量和定性数据。从80名2型糖尿病患者那里收集了定量数据，使用经过验证的工具：足部护理知识问卷、糖尿病足自我管理行为量表以及技术接受与使用统一理论问卷。皮尔逊相关分析和回归分析考察了知识、行为和技术采用意图之间的关系。对20名参与者的深入半结构化访谈探讨了采用因素。定性数据进行了主题分析。

结果： 尽管足部护理知识水平较高（86.2%的正确回答率），实际自我管理行为仍不理想，知识与行为之间仅有适度的相关性（r = 0.31且p

结论： 本研究发现，尽管相比过去的几十年足部护理的知识水平有所提高，糖尿病足护理中的“知行差距”依然存在。结果表明，成功实施智能健康技术需要同时解决态度因素和便利条件问题，而不仅仅是注重知识的提升。这些见解有助于理解慢性病自我管理中技术采用的情况，并为制定更有效的实施策略提供信息。

关键词： 糖尿病足护理；卫生知识；混合方法研究；自我管理行为；智能健康技术；技术接受度；2型糖尿病。