Communication techniques for improved acceptance and adherence with therapeutic footwear

Netten, Jaap J. van; Francis, Anthony; Morphet, Ashley; Fortington, Lauren V; Postema, Klaas; Williams, Anita

doi:10.1177/0309364616650080

Cited by 28 publications

(23 citation statements)

References 18 publications

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“…The important contribution of footwear to people’s identity and self-expression is well recognised28 29 and was a significant concern for both male and female participants in our study, although good fit and comfort were prioritised.…”

Section: Discussionmentioning

confidence: 73%

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

et al. 2019

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ObjectivesAdults with knee instability related to neuromuscular disorders or central nervous conditions often experience mobility problems and rely on orthoses to improve function and mobility. Patient views of device effectiveness and acceptability are underexplored. Our study aimed to elicit device users’ perspectives regarding fitting, acceptability, effectiveness and use of orthoses, and identify important treatment outcomes.DesignQualitative descriptive study using in-depth semistructured interviews. Interview transcriptions were coded and thematically analysed, using ‘Framework’.Setting and participantsA purposive sample of 24 adult users of orthotic devices. Nineteen patients were recruited across three National Health Service sites, and five people through charities/patient support groups in England. Half of the participants had been diagnosed with poliomyelitis, and the remainder with multiple sclerosis, Charcot-Marie-Tooth disease, spinal injury or spina bifida, and stroke. The median age of participants was 64.5 years (range 36–80 years).ResultsPatients’ medical condition impacted significantly on daily life. Participants relied on orthotic devices to enable engagement in daily activities. Patient goals for mobility were linked to individual circumstances. Desired treatment outcomes included reduction in pain, trips and falls, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses and associated with reported use. Obtaining suitable footwear alongside orthotic devices was a significant concern. Time pressures during device fitting were viewed negatively.ConclusionsOrthotic devices for knee instability play a crucial role in promoting, maintaining and enhancing physical and psychological health and well-being, enabling patients to work, engage in family life and enjoy social activities. Future research should consider how best to measure the impact of orthotic devices on patient quality of life and daily functioning outside the clinic setting, as well as device use and any adverse effects.Trial registration numberThis qualitative study was retrospectively registered as Current Controlled Trials ISRCTN65240228.

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Section: Discussionmentioning

confidence: 73%

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

et al. 2019

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“…These personal values and experiences cannot be assessed using a standardised measurement device. Adequate communication between healthcare professionals and patients is needed to assess these perceptions [ 45 , 50 ]. For this communication to be effective, it should be person-centred, not footwear-centred [ 45 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Foot Australia guideline on footwear for people with diabetes

Netten

Lazzarini

Armstrong

et al. 2018

Journal of Foot and Ankle Research

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113

184

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BackgroundThe aim of this paper was to create an updated Australian guideline on footwear for people with diabetes.MethodsWe reviewed new footwear publications, (inter)national guidelines, and consensus expert opinion alongside the 2013 Australian footwear guideline to formulate updated recommendations.ResultWe recommend health professionals managing people with diabetes should: (1) Advise people with diabetes to wear footwear that fits, protects and accommodates the shape of their feet. (2) Advise people with diabetes to always wear socks within their footwear, in order to reduce shear and friction. (3) Educate people with diabetes, their relatives and caregivers on the importance of wearing appropriate footwear to prevent foot ulceration. (4) Instruct people with diabetes at intermediate- or high-risk of foot ulceration to obtain footwear from an appropriately trained professional to ensure it fits, protects and accommodates the shape of their feet. (5) Motivate people with diabetes at intermediate- or high-risk of foot ulceration to wear their footwear at all times, both indoors and outdoors. (6) Motivate people with diabetes at intermediate- or high-risk of foot ulceration (or their relatives and caregivers) to check their footwear, each time before wearing, to ensure that there are no foreign objects in, or penetrating, the footwear; and check their feet, each time their footwear is removed, to ensure there are no signs of abnormal pressure, trauma or ulceration. (7) For people with a foot deformity or pre-ulcerative lesion, consider prescribing medical grade footwear, which may include custom-made in-shoe orthoses or insoles. (8) For people with a healed plantar foot ulcer, prescribe medical grade footwear with custom-made in-shoe orthoses or insoles with a demonstrated plantar pressure relieving effect at high-risk areas. (9) Review prescribed footwear every three months to ensure it still fits adequately, protects, and supports the foot. (10) For people with a plantar diabetic foot ulcer, footwear is not specifically recommended for treatment; prescribe appropriate offloading devices to heal these ulcers.ConclusionsThis guideline contains 10 key recommendations to guide health professionals in selecting the most appropriate footwear to meet the specific foot risk needs of an individual with diabetes.

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“…Research has highlighted the importance of the patient/professional relationship, explaining how a good relationship can even increase the likelihood of adherence with medical interventions [28] and satisfaction [29]. In relation to prescribed footwear, both Williams, Nester and Ravey (2016) [30] and Van Netten et al (2017) [31] identi ed that effective communication techniques could improve acceptance of footwear as a health intervention and hence outcomes with it. It was also important to users to maintain continuity in their care to allow for open and honest conversations about their requirements.…”

Section: Discussionmentioning

confidence: 99%

“…When prescribing orthotic devices services should give thought and consideration to the potential impact on body image that the device may have and ways these can be accommodated for service users to increase the likelihood of acceptance and satisfaction and hence outcomes. Some recent work focusing on acceptance of therapeutic footwear expressed the need to employ effective communication techniques to assist patients to be involved in choosing their footwear, rather than passively receive them [31] These service users expressed frustrations related to what they felt where lengthy waiting times to receive their orthoses. This appeared to impact heavily on their perception of their quality of care and satisfaction with orthotic services.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study of User Perspectives on Outcomes of Orthotic Interventions

Hall

Parker

Williams

2020

Preprint

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Background: Orthotic services offer various health benefits and it is estimated that for every £1 spent on orthotic care the savings to the NHS are up to £4. Several reports into orthotic services in the UK have reported a lack of data relating to outcomes of orthotic care. This lack of data means it is difficult to demonstrate the overall efficacy of orthotic services. There is also lack of clarity about the influences on positive outcomes and we do not know what outcomes are relevant to users. This qualitative study aimed to explore the influences on outcomes of orthotic interventions and opinions on outcome measurement from the user’s perspective. Method: An advisory group involving experts in the field along with a review of the literature was conducted. From this, semi-structured questions were developed, ethical approval obtained, and a focus group was undertaken with five users. Data was transcribed and analysed using thematic analysis.Results: The participants expressed a need for orthotic provision which enables them to function physically and psychologically in the context of all life’s activities. Current practice neglects the impact of altered body image and there is dissatisfaction related to waiting times, impacting on their desired outcomes. However, they expressed positive thoughts about the patient professional relationship and being involved in decision making. They identified fundamental issues around usability of three current outcome measure tools with no one outcome measurement tool being suitable for their complex conditions and interventions. Conclusions: Communication of the clinicians understanding about the physical, psychological and socio-economic impact of living with a chronic condition, being involved in decision making, continuity of care and timeliness of provision were identified as key factors influencing positive health outcomes. Due to the complexity of conditions presenting to orthotic services it would seem that there needs to be a range of outcome measures specific to the user’s condition and the orthoses provided for it. Mutually agreed and individualised goal setting may be a solution that ensure the user can self-monitor positive health gains and services can provide evidence for effective outcomes.

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Communication techniques for improved acceptance and adherence with therapeutic footwear

Cited by 28 publications

References 18 publications

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

Diabetic Foot Australia guideline on footwear for people with diabetes

A Qualitative Study of User Perspectives on Outcomes of Orthotic Interventions

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