Foot health education for people with rheumatoid arthritis

NewsBot · Sep 1, 2012

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Foot health education for people with rheumatoid arthritis - some patient perspectives
Andrea S Graham, Alison Hammond, Steven Walmlsey and Anita E Williams
Journal of Foot and Ankle Research 2012, 5:23

Background
Patient education is an important component of foot health management for people with rheumatoid arthritis (RA). The content and strategies for delivery require investigation in relation to the patients' needs. This study explores patients' experiences of foot health education, to inform how the patients' needs could be identified in clinical practice and inform effective education delivery.

Method
A focus group was used to collect data. The dialogue was recorded digitally, transcribed verbatim and analysed using a structured thematic approach. Member checking and peer review added to credibility of the data.

Six themes emerged; (i) content and purpose of patient education -- what it should be, (ii) content of patient education -- what it should not be, (iii) timing of information on foot health, (iv) method of delivery, (v) ability to engage with foot health education and (vi) the patient/practitioner relationship.

Conclusions
This study identified aspects of patient education considered important by this group of patients in relation to content, timing and delivery, forming the basis for further research on clinical and patient focussed outcomes of patient education.

Identifying health education needs and provision of supportive verbal and written information can foster an effective therapeutic relationship, supporting effective foot health education for people with RA.
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Admin2 · Sep 1, 2012

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NewsBot · Jun 16, 2015

Foot Health Education for People with Rheumatoid Arthritis: '…. A Game of Chance…' – A Survey of Patients' Experiences
Andrea S. Graham andAnita E. Williams
Musculoskeletal Care; Early View

Objective
Up to 90% of people with rheumatoid arthritis (RA) experience foot problems leading to reduced function, mobility, quality of life and social participation, and impacts on body image, but these can be improved with general foot care, orthoses, footwear and patient education. Foot health patient education is lacking, so the aim of the present study was to identify the foot health educational needs of people with RA in relation to its content, timing, mode of delivery and the perceived barriers to its provision.

Methods
People with RA completed an online survey and provided free-text comments for thematic analysis.

Results
A total of 249 people completed the free-text section of the survey. Five main themes emerged: ‘Forgotten feet’; ‘Too little, too late’; ‘Lacks and gaps’; ‘I am my feet’ and ‘Game of chance’.

Conclusion
Foot pathology in people with RA has a bio-psychosocial impact on their lives. Foot health and related information appears to be considered rarely within the medical consultation. Access to foot health information and services is limited owing to a lack of patient and/or health professional awareness, with a detrimental impact on the prognosis of their foot health. The importance of foot health in people with RA should be reinforced for patients and health professionals alike. Opportunities to discuss foot health within the medical consultation should be provided regularly
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NewsBot · Jun 27, 2015

Therapeutic foot health education for patients with rheumatoid arthritis: a narrative review.
Graham A, Hammond A, Williams A.
Musculoskeletal Care. 2011 Sep;9(3):141-51

PURPOSE:
Foot health interventions such as foot orthoses for people with rheumatoid arthritis (RA) reduce pain, improve function and improve overall quality of life. Additionally, patient education (PE) is considered essential in achieving good outcomes with interventions such as foot orthoses, footwear and self-care. The aim of this literature review was to identify evidence in relation to the content, use and delivery of PE in the management of RA foot problems.
METHODS:
An electronic search of the following databases was performed: PubMed, CINAHL, AMED, Medline and the Cochrane Library, between March 2000 and March 2010. In order to be included, studies had to be published in English, involve adults (>18 years) with RA, and assist in answering the research question. No publications regarding PE for the management of foot health-related problems in RA were found. However, other key terms emerged that embraced PE for people with RA and informed a further search. Thirty-two papers met the inclusion criteria and were reviewed with regard to the subject area, content of the paper, methodological issues and their key findings.
RESULTS:
The present review provides evidence for the effectiveness of PE for people with RA delivered via a staged approach, with the content and timing of education provision being driven by the needs of the patient.
CONCLUSIONS:
The effect of PE delivered from a podiatric context needs to be explored, and the nature and requirements of PE for individuals with RA-related foot problems from a patient and practitioner perspective requires investigation. Alternative and innovative ways of providing PE and, potentially, self-management need to be investigated and defined.
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NewsBot · Apr 27, 2016

Foot health education provision for people with rheumatoid arthritis–an online survey of UK podiatrists’ perceptions
Andrea S Graham and Anita E Williams
Journal of Foot and Ankle Research 2016 9:13

Background
Patient education supports general disease self-management and in relation to foot problems, it is recommended as a key intervention for people with rheumatoid arthritis (RA). Further, it is known what the foot health educational (FHE) needs are in relation to their experiences of foot problems. Podiatrists are the key health professionals who provide the management of RA-related foot pathology and this includes the delivery of FHE. However, we do not know what is currently provided and what podiatrists’ perceptions are of this intervention. It is possible that there is a difference between what is provided and what patients need in order to maximise their foot health benefits and hence this may contribute to the persistence of foot problems and symptoms. This study primarily aims to define what UK podiatrists’ perceptions of FHE are in relation to; what is delivered, how it is delivered, and the timing of its delivery, in the context of its’ accessibility. The secondary aim is to identify any influence of the participants’ gender, age and duration of professional qualification on their responses.

Method
An online survey of UK HCPC registered podiatrists was used to capture quantitative data in relation to the perceived; aims, content, methods and effectiveness, timing and barriers to FHE provision to people with RA. Data was analysed to assess significant associations between the participant responses and their gender, age and duration of professional qualification. Free text comments were analysed using thematic analysis.

Results
43 podiatrists across the UK completed the survey. The majority of participants stated that, they provided FHE and agreed with its overall aims. The most common methods of delivery that were perceived to be most effective were: verbal, written and website based information. The best times at which to deliver FHE were thought to be at the point of diagnosis of RA and at any available opportunity of health care delivery. The majority of participants thought they had enough knowledge and access to information resources to effectively deliver FHE, but half of the participants felt that consultation duration limited their ability to do so. Gender and duration of professional qualification influenced participants’ perceptions of FHE.

Conclusion
The importance and content of FHE for people with RA has been defined, but time limitations are seen to restrict its delivery. The development of an education needs analysis tool to facilitate efficient identification of patients FHE needs could enable timely and tailored delivery of FHE to people with RA.
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NewsBot · May 17, 2016

Foot Health Education for People with Rheumatoid Arthritis: A Survey of Patients’ Perceived Needs and Experiences

NewsBot · Jan 26, 2017

The experience of foot problems and decisions to access foot care in patients with rheumatoid arthritis: a qualitative study
Oonagh Wilson, John Kirwan, Emma Dures, Enid Quest and Sarah Hewlett
Journal of Foot and Ankle Research201710:4

Background
Although foot problems are common in rheumatoid arthritis (RA), the consequences of foot problems from the patient perspective have not been fully explored. The aims of this study were to explore the experience of foot problems and decisions to access foot care services or not in patients with RA.

Methods
Semi structured, one-to-one interviews with patients recruited from 2 UK rheumatology units, purposively sampled for self-reported foot problems and a range of personal/disease characteristics. Inductive thematic analysis was used, with rigour provided by multiple independent analysers. Emerging themes were discussed and agreed by all authors.

Results
Twelve patients participated: 7 female; mean age 56 years (29–72); mean disease duration 12 years (2–27), 5 had accessed foot care services. The ‘Impact’ of foot problems was substantial and formed the underpinning theme, comprising three organising themes: ‘Foot symptoms’; ‘Consequences’; and ‘Cost’. Foot symptoms such as pain and numbness required self-management, and affected daily life (walking, working) leading to social and emotional costs. The global theme, ‘Decision to access foot care or not’, also comprised three organising themes: ‘Access perceived unnecessary’ (no problem, can cope); ‘Access hindered by patients’ perception’; and ‘Access supported by patient and clinician’. Decisions to access foot care or not were complex and influenced by patient beliefs regarding possible treatments and how to access these, and hindered by patient perceptions that their feet were ignored by rheumatology clinicians. Positive experience of foot care encouraged continued utilisation but negative experiences contributed to patients’ decisions to discontinue foot care services.

Conclusions
Foot problems are important issues for patients and impact on many aspects of their physical, social and emotional lives. Patients who had accessed foot care services prioritised their foot problems as an important health care need. However, for others who would like foot care services, personal knowledge and values, and perceived barriers in clinical practice, appear to interact to inhibit foot care access. The extent which these interactions affect overall access to foot care in RA patients in general now needs to be quantified to help to inform and improve the effectiveness of the organisation and delivery of foot care.
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NewsBot · Mar 8, 2017

A survey of people with foot problems related to rheumatoid arthritis and their educational needs
Andrea S. Graham, John Stephenson, and Anita E. Williams
Journal of Foot and Ankle Research201710:12

Background
Up to 50% of people with rheumatoid arthritis (RA) have foot symptoms at diagnosis, hence early foot health intervention is recommended and this should include patient education. This study identifies, for the first time, the foot health education (FHE) needs of people with RA.

Methods
An online survey of people with RA (n = 543) captured quantitative data in relation to the aims, methods of delivery, content, timing and accessibility of FHE.

Results
The majority concurred about the aims of FHE. Verbal delivery and websites were the most common methods. Written and verbal FHE were perceived to be the most effective methods. The point of diagnosis was the preferred time to receive it. Lack of access to FHE included minimal focus on foot health during consultations by both health practitioners and patients with RA. Participant gender, age, disease duration and living situation had a statistically significant influence on the results.

Conclusion
Foot health education is rarely considered within the medical consultation. There is a lack of patient and/or health professional awareness of this need with a detrimental impact on foot health. Patients require health professionals to identify their foot education health needs. Tailored foot health education should begin at initial diagnosis.
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NewsBot · Apr 10, 2018

Foot Health Education
For People with Rheumatoid Arthritis
Andrea Graham
University of Salford, UK March 2018

Foot problems for people with rheumatoid arthritis (RA) are common resulting in
significant pain, activity restriction and reduced quality of life. Provision of information
and health education in respect of foot health would therefore seem to be an
essential aspect of foot health management for people with RA, in order to maintain
their foot health and overall well being. Although educational resources exist for this
group of people, their exact needs and preferred methods of receiving education
about foot health have not been formally sought.
The aim of this body of work was to investigate patients’ and podiatrists’ perspectives
of current foot health education provision for people with RA in the UK; firstly aiming
to identify any evidence to support the use of foot health education, then exploring
patient and podiatry practitioner experiences of foot health education provision. This
thesis therefore presents seven works published between 2011 and 2017 that
explore the perceptions of people with RA and podiatrists about foot health education
provision in the UK.
This body of work has been critically reviewed through; personal reflection of the
author’s perceptions of patient education and in the context of the work within the
public domain. The methodological approaches used, the wider impact of the work
and its’ translation into practice have been critically evaluated through analysis of
citation/download and Altmetric data and review of the current literature,
demonstrating the works’ broad utilisation and impact.
This work demonstrates an original and distinctive contribution to research design
within the podiatry profession, the understanding of foot health education needs of
people with RA and the continuing significant burden that diminished foot health has
on this population of people.
Overall, the publications within this thesis have culminated in the identification of the
need for future research to develop a foot-health related educational needs analysis
tool that will facilitate a more timely and tailored approach to FHE provision.
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NewsBot · Jul 13, 2023

INVESTIGATION OF KNOWLEDGE ABOUT FOOT HEALTH IN
PATIENTS WITH RHEUMATOID ARTHRITIS
Bağlan Yentür et al.
Source

Aim: Foot involvement is frequently observed in patients with rheumatoid arthritis (RA). However, the knowledge about foot health in
patients with RA is limited and the awareness of physicians is not sufficient. The purpose of this study was to investigate knowledge
about foot health and related factors in patients with RA.
Material and Methods: This study included 115 patients diagnosed with RA. Demographics of patients were recorded. The Overall Foot
Health Questionnaire (OFHQ), Foot Function Index (FFI), and Health Assessment Questionnaire (HAQ) were used to evaluate knowledge
level about foot health, foot function, and general health status, respectively.
Results: The study was completed with 111 patients with RA. It was found that the foot health knowledge level of patients with RA was
9.03±3.9, out of 18. A significant difference was found in gender, occupation, smoking, and education level according to OFHQ, and
correlation was found between OFHQ and disability subscale of FFI (p<0.05). There was no significant correlation between OFHQ and
pain and activity restriction subscales of FFI and HAQ (p>0.05).
Conclusion: It was found moderate level of knowledge of foot health in patients with RA. Therefore, it is important to provide more
information about foot health protection and to include patients’ education as a part of treatment.
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