“Come and live with my feet and you'll understand” – a qualitative study exploring the experiences of retail footwear in women with rheumatoid arthritis

Abstract

BackgroundFoot pain and deformity are common in people with rheumatoid arthritis (RA). Previous research has identified that women with RA seek retail footwear to alleviate their foot problems. The specific footwear features that women with RA require, and what would help them to find shoes that meet these requirements, are unknown. This study aimed to determine the factors that influence the choice of appropriate retail footwear by women with RA.MethodAn overarching qualitative approach was taken, using reflexive thematic analysis of conversational style interviews. The interviews explored experiences and use of retail footwear in 20 women with RA. The interviews were digitally recorded transcribed verbatim and analysed using a reflexive thematic framework.ResultsWomen with RA sought retail footwear which had adequate cushioning, width, a flexible sole, lightweight, were made from breathable materials and were easy to put on and take off. However, this choice was driven by the need for comfort, cost and usability, with aesthetics being less of a priority. Despite having opinions on what criteria they felt that they needed, these women did not feel empowered to make good choices about purchasing retail footwear for symptomatic relief. Furthermore, they did not receive the necessary support from podiatrists and shoe shop staff.ConclusionWomen with RA have clear ideas about what features a retail shoe should have to achieve comfort. There is a constant compromise between achieving comfort and their feelings about their appearance and how they feel others perceive them. Women with RA describe negative experiences with shoe shop assistants and podiatrists leading to poor footwear choices. Both retail staff and podiatrists need increased understanding about the particular problems that women with RA experience.

Factors associated with type of footwear worn inside the house: a cross‐sectional study

“…The predominance of slippers and thongs/flip flops fits with what we know about considerations when purchasing indoor footwear in some specific populations such as older people and women with rheumatoid arthritis, where comfort and the convenience of not bending down to don and doff are important [3, 7]. The large proportion of people preferring to go without footwear in the home is also perhaps not surprising, especially given the warm climate of Queensland, Australia from which this sample was drawn.…”

“…The large proportion of people preferring to go without footwear in the home is also perhaps not surprising, especially given the warm climate of Queensland, Australia from which this sample was drawn. Further, there are sometimes cultural and religious reasons for not wearing footwear or wearing slip-on footwear in some indoor areas [3, 31]. These contextual factors should be considered when making clinical recommendations.…”

“…Footwear protects the feet from the environment, provides a supportive surface between the feet and the ground [1] and has psychological and sociocultural significance [2, 3]. Some specific populations also have special footwear needs because of health conditions that increase their risk of experiencing falls [4] or developing foot ulcers, such as those with diabetes [5].…”

Important features of retail shoes for women with rheumatoid arthritis: A Delphi consensus survey

“…Furthermore, therapeutic footwear is often not accepted by women, which reduces wearing adherence and therefore the opportunity to achieve therapeutic benefit is lost [7]. Lack of adherence with therapeutic footwear is multi-factorial, often compounded by a lack of acceptance of their underlying condition, and a disparity in expectations of the footwear [3, 7, 8]. This non-acceptance of therapeutic footwear results in many women seeking retail footwear as an alternative.…”

“…Women with RA have particular footwear requirements, with many presenting with foot pain and deformity which makes fitting retail footwear difficult [4]. Furthermore, women associate aspects of their identity and femininity with their footwear choices [8, 9]. The presence of RA can negatively impact on choice, and an ideal shoe should accommodate deformity and offer comfort, whilst offering the women choices in style [8].…”