Patient and professional perspectives on prescribed therapeutic footwear for people with diabetes: A vignette study.
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Patient Educ Couns. 2006 Feb 7; [Epub ahead of print]
Johnson M, Newton P, Goyder E.
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I have a patient who continually refuses to wear 'grandma shoes' which by their definition is anything closed in with a lace. It is important to consider the patients perspective but one would think it slightly more important to advise more 'appropriate' and 'fitted' footwear, especially in cases where the diabetic foot has significantly changed shape. The patient's perspective that pointed toed high heels 'look great' when the forefoot is twice the size it's meant to be and almost at right angles to the rest of the foot doesn't really seem a viable one to me.
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Patient perceptions of stock footwear design features.
Prosthet Orthot Int. 2006 Apr;30(1):61-71
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I have found that most patients who qualify for the Diabetic shoe program here not only do not mind the shoes,they will insist on getting their pair.The shoes can help prevent ulcerations and the nice part,if you will is that they come at either no or little cost to the patient.Heck,even my office staff knows the drill..."Dr.Spina,this patient is a diabetic..please give her/him a pair of shoes.."
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It doesnt quite work like that here in the UK.
Patients have to be seen in a Diabetic Foot Clinic, the Pod then has to get a form signed by a Diabetologist. The patient then sees an Orthotist who either has a bespoke pair of shoes made (cost £150+ ) or a modified stock pair (cost £80+) or stock pair (cost£60+). These are provided free of charge to the patient, who may o may not wear them. An insole may or may not be provided (by orthotist or podiatrist) and the patient may of waited up to 3/4months for the shoes, so the foot may of changed shape again in the meantime and the shoes may not fit!!
The mentality in the UK is that if it is for free I'll take it but may or may not wear it!
patients tend to wear the footwear provided only when the feet have changed shape so much that they cannot fit them into 'standard' footwear.
The VAST majority of Diabetic aptients in the UK use standard footwar, we try to recommend Training shoes, as these are a good compromise (and yes we know they are a compromise, but its the best compromise available) -
Robby:The same here.I DO have to have a doctor sign off on a form before it can be approved.They get 1 pair of shoes per year.The patients like this service and ask for it.I refer them to the pedorthist for the shoes,as stocking them and doing it myself appears to be,while profitable,a pain in the rump...besides,I go to a few offices and make house calls,so where in blazes will I keep the shoes?I do not make the big profit on it.All I get out of it is an increased supply of happy patients!
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Use and usability of custom-made orthopedic shoes.
van Netten JJ, Jannink MJ, Hijmans JM, Geertzen JH, Postema K.
J Rehabil Res Dev. 2010;47(1):73-81.
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Patients' expectations and actual use of custom-made orthopaedic shoes.
van Netten JJ, Jannink MJ, Hijmans JM, Geertzen JH, Postema K.
Clin Rehabil. 2010 Oct;24(10):919-27. Epub 2010 Jun 24.
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Long-term use of custom-made orthopedic shoes: 1.5-year follow-up study.
van Netten JJ, Jannink MJ, Hijmans JM, Geertzen JH, Postema K.
J Rehabil Res Dev. 2010;47(7):643-9.
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"Münsteraner foot- and shoe score" - objectivation of patient satisfaction after provision with orthopedic shoes
Illgner U, Schnieder K, Seintsch H, Osada N, Wetz HH.
Z Orthop Unfall. 2011 Aug;149(4):418-23.
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I have found that I cannot trust the information gleaned from them in any verbal sense regarding the problem a lot of the time. Some yes, but most no. Unfortunately. They recognise an "issue" but do not recognise the severity of it. They tend to mix mis information with half rememberances of visits and talks along the way with all the different practitioners and "well meaning" friends who see them.
A lot of denial seems to prevail in this population. (The patient presenting with wounds secondary to type 2)
However, I have noted an increase in those of the denial group once presenting with a second wound...they are oddly enough now convinced that they should follow along and follow up.
I like it when they follow up with all of us. And really as long as the team is all working together for the same goal It works..
I dislike it when you get to know them they start to get lazy with the care and then you read about them. It seems to happen all too often. Epidemic indeed...makes a horrible mess of people both physically and mentally. You can see it happen over time.. -
Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA)
Joanne S Paton, Anne Roberts, Graham K Bruce and Jonathan Marsden
Journal of Foot and Ankle Research 2014, 7:16 doi:10.1186/1757-1146-7-16
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Footwear Appropriateness, Preferences and Foot Ulcer Risk Among Adult Diabetics at Makati Medical Center Outpatient Department
Joie DJ Isip, Milldeanna de Guzman, Andres Ebison Jr., Carolyn Narvacan-Montano
Isip; Vol 31, No 1 (2016)
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Communication techniques for improved acceptance and adherence with therapeutic footwear
Jaap J van Netten et al
Prosthet Orthot Int June 8, 2016
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I had a patient who really was in pain, it was obvious that she was wearing high heels. When questioned she denied this. After a while i refereed her to a orthopedic surgeon.
After his examination, he asked her the same question. He was a Harley street man who spoke with a very posh accent. When she said no to this question. He replied Madam you are a liar!. she took it from him at great expense to her.
The resistance to advice on footwear can be a problem. -
Perceived role of therapeutic footwear in the prevention of diabetic foot ulcers: A survey of patients with diabetes mellitus in Kaduna State
Tagang I Jerry et al
Niger J Basic Clin Sci 2016;13:78-84
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Adherence to wearing therapeutic shoes among people with diabetes: a systematic review and reflections.
Jarl G et al
Patient Prefer Adherence. 2016 Aug 8
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Orthopedic shoes: Still in touch with the times?
Greitemann B
Z Rheumatol. 2015 Nov;74(9):786-92.
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Patient’s perspective with regards to wearing diabetic therapeutic footwear : an interpretative phenomenological analysis
Borg, Anthea
B.SC.(HONS)PODIATRY Thesis 2016; University of Malta
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Foot anthropometrics in individuals with diabetes compared with the general Swedish population – Implications for shoe design
Ulla Hellstrand Tang, Jacqueline Siegenthaler, Kerstin Hagberg, Jon Karlsson, Roy Tranberg
The Foot and Ankle Online Journal 10 (3): 1
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Adherence Over Time: The Course of Adherence to Customized Diabetic Insoles as Objectively Assessed by a Temperature Sensor.
Ehrmann D et al
J Diabetes Sci Technol. 2017 Dec 1:1932296817747618. doi: 10.1177/1932296817747618
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An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration.
Renske Keukenkamp, Maarten J. Merkx, Tessa E. Busch-Westbroek, and Sicco A. Bus
Journal of the American Podiatric Medical Association: March 2018, Vol. 108, No. 2, pp. 90-99.
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Gender differences in attitudes and attributes of people using therapeutic shoes for diabetic foot complications
Gustav Jarl, John Alnemo, Roy Tranberg and Lars-Olov Lundqvist
Journal of Foot and Ankle Research201912:21
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Attitudes and attributes of women and men using therapeutic shoes for diabetic foot complications
Alnemo, John
In: 8th International symposium on diabetic foot: Absttaract book, 2019, p. 117-117, article id P35.05
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Predictors of adherence to using therapeutic shoes among people with diabetic foot complications
Jarl, Gustav
In: 8th International symposium on diabetic foot: Abstract book, 2019, p. 108-109, article id P32.03
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Evaluation of the use of therapeutic footwear in people with diabetes mellitus - a scoping review.
Jorgetto JV et al
J Diabetes Metab Disord. 2019 Aug 14 ;18(2):613-624
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The predictive value of quality of life and attitude
towards orthopaedic shoes on number of steps a
diabetes patient with foot problems takes per day
Anke Scholten
Master Health Psychology and Technology, University of Twente
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Custom-made footwear designed for indoor use increases short-term and long-term adherence in people with diabetes at high ulcer risk
Renske Keukenkamp et al
BMJ Open Diabetes Res Care. 2022 Feb;10(1):e002593
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Perceptions of protective shoes and recommendations from patients
with diabetic foot ulcers
Yiru Wang et al
Global Health & Medicine
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Perceptions of protective shoes and recommendations from patients with diabetic foot ulcers
Yiru Wang et al
Glob Health Med. 2023 Oct 31;5(5):306-310.
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Predictors of healing and functional outcome following transmetatarsal amputations
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Gene therapy for diabetes
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