Short Report: Complications Cognitive representations of peripheral neuropathy and self-reported foot-care behaviour of people at high risk of diabetes-related foot complications B. M. Perrin 1 , H. Swerissen 2 , C. B. Payne 3 and T. C. Skinner 4 1 La Trobe Rural Health School, 2 Faculty of Health Sciences, 3 Department of Podiatry, La Trobe University, Bendigo, Vic., and 4 School of Psychological and Clinical Sciences, Charles Darwin University, Darwin, NT, Australia Accepted 17 July 2013 Abstract Aim The aim of this study was to explore the cognitive representations of peripheral neuropathy and self-reported foot-care behaviour in an Australian sample of people with diabetes and peripheral neuropathy. Methods This cross-sectional study was undertaken with 121 participants with diabetes and peripheral neuropathy. Cognitive representations of peripheral neuropathy were measured by the Patients’ Interpretation of Neuropathy questionnaire and two aspects of self-foot-care behaviour were measured using a self-report questionnaire. Hierarchical cluster analysis using the average linkage method was used to identify distinct illness schemata related to peripheral neuropathy. Results Three clusters of participants were identified who exhibited distinct illness schemata related to peripheral neuropathy. One cluster had more misperceptions about the nature of peripheral neuropathy, one cluster was generally realistic about the nature of their condition and the final cluster was uncertain about their condition. The cluster with high misperceptions of their condition undertook more potentially damaging foot-care behaviours than the other clusters (F = 4.98; P < 0.01). Conclusions People with diabetes and peripheral neuropathy have different illness schemata that may influence health-related behaviour. Education aimed at improving foot-care behaviour and foot-health outcomes should be tailored to specific illness schemata related to peripheral neuropathy. Diabet. Med. 31, 102–106 (2014) Introduction The burden of foot morbidity secondary to diabetes is substantial and likely to grow with the increasing prevalence of diabetes. Although there has been rapid growth in our understanding of the aetiology of foot complications, success in decreasing the incidence rates of lower-limb amputation is limited to distinct populations [1]. The common-sense model of illness behaviour postulates that illness-specific belief systems determine people’s behavioural responses to illness [2]. In diabetes, a number of studies have demonstrated support for this model, with interventions based on this model being shown to be efficacious [3,4]. The model proposes that there are five domains of cognitive representations associated with the experience of a health condition—the diagnostic label (identity), the expected duration (timeline), the expected outcomes (consequences), the believed cause (cause) and perceived treatment/control of the condition [5]. Vileikyte and colleagues have developed a peripheral neuropathy-specific questionnaire to assess these beliefs [the Patients’ Interpretation of Neuropathy (PIN) questionnaire [6]]. Although they showed relationships between beliefs and foot care, the dimensions were examined in isolation rather than as interactive multidimensional representations, as hypothesized by the common-sense model of illness [7]. One way to address this is to use cluster analysis, which can identify groups of individuals with similar multidimen- sion beliefs systems, and may have the potential to improve the predictive value over looking at illness dimensions in isolation [7]. Using this approach, we sought to explore the relationship between neuropathic-specific illness Correspondence to: Byron Matthew Perrin. E-mail: b.perrin@latrobe.edu.au 102 ª 2013 The Authors. Diabetic Medicine ª 2013 Diabetes UK DIABETICMedicine DOI: 10.1111/dme.12287