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Published in: Journal of Foot and Ankle Research 1/2017

Open Access 01-12-2017 | Research

A survey of people with foot problems related to rheumatoid arthritis and their educational needs

Authors: Andrea S. Graham, John Stephenson, Anita E. Williams

Published in: Journal of Foot and Ankle Research | Issue 1/2017

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Abstract

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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Literature
1.
go back to reference Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 2008;79:257–61. doi:10.1080/17453670710015067.CrossRefPubMed Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 2008;79:257–61. doi:10.​1080/​1745367071001506​7.CrossRefPubMed
2.
3.
go back to reference Barn R, Turner DE, Rafferty D, Sturrock RD, Woodburn J. Tibialis posterior tenosynovitis and associated pes plano valgus in rheumatoid arthritis: electromyography, multisegment foot kinematics, and ultrasound features. Arthritis Care Res (Hoboken). 2013;65:495–502. doi:10.1002/acr.21859.CrossRef Barn R, Turner DE, Rafferty D, Sturrock RD, Woodburn J. Tibialis posterior tenosynovitis and associated pes plano valgus in rheumatoid arthritis: electromyography, multisegment foot kinematics, and ultrasound features. Arthritis Care Res (Hoboken). 2013;65:495–502. doi:10.​1002/​acr.​21859.CrossRef
4.
go back to reference Hooper L, Bowen CJ, Gates L, Culliford DJ, Ball C, Edwards CJ, et al. Prognostic indicators of foot-related disability in patients with rheumatoid arthritis: results of a prospective three-year study. Arthritis Care Res (Hoboken). 2012;64:1116–24. doi:10.1002/acr.21672. Hooper L, Bowen CJ, Gates L, Culliford DJ, Ball C, Edwards CJ, et al. Prognostic indicators of foot-related disability in patients with rheumatoid arthritis: results of a prospective three-year study. Arthritis Care Res (Hoboken). 2012;64:1116–24. doi:10.​1002/​acr.​21672.
5.
go back to reference Woodburn J, Helliwell PS, Barker S. Three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfoot. Rheumatology (Oxford). 2002;41:1406–12.CrossRef Woodburn J, Helliwell PS, Barker S. Three-dimensional kinematics at the ankle joint complex in rheumatoid arthritis patients with painful valgus deformity of the rearfoot. Rheumatology (Oxford). 2002;41:1406–12.CrossRef
6.
go back to reference Firth J. Lower limb ulceration in rheumatoid arthritis. Nurs Times. 2008;104:38–40.PubMed Firth J. Lower limb ulceration in rheumatoid arthritis. Nurs Times. 2008;104:38–40.PubMed
7.
go back to reference Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, et al. Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial. Clin Rheumatol. 2013;32:567–74. doi:10.1007/s10067-012-2134-x.CrossRefPubMed Siddle HJ, Redmond AC, Waxman R, Dagg AR, Alcacer-Pitarch B, Wilkins RA, et al. Debridement of painful forefoot plantar callosities in rheumatoid arthritis: the CARROT randomised controlled trial. Clin Rheumatol. 2013;32:567–74. doi:10.​1007/​s10067-012-2134-x.CrossRefPubMed
10.
go back to reference Otter SJ, Young A, Cryer JR. Biologic agents used to treat rheumatoid arthritis and their relevance to podiatrists: a practice update. Musculoskeletal Care. 2004;2:51–9.CrossRefPubMed Otter SJ, Young A, Cryer JR. Biologic agents used to treat rheumatoid arthritis and their relevance to podiatrists: a practice update. Musculoskeletal Care. 2004;2:51–9.CrossRefPubMed
11.
go back to reference Wilske KR. Inverting the therapeutic pyramid: observations and recommendations on new directions in rheumatoid arthritis therapy based on the author’s experience. Semin Arthritis Rheum. 1993;23(2 Suppl 1):11–8.CrossRefPubMed Wilske KR. Inverting the therapeutic pyramid: observations and recommendations on new directions in rheumatoid arthritis therapy based on the author’s experience. Semin Arthritis Rheum. 1993;23(2 Suppl 1):11–8.CrossRefPubMed
12.
go back to reference Wickman AM, Pinzur MS, Kadanoff R, Juknelis D. Health-related quality of life for patients with rheumatoid arthritis foot involvement. Foot Ankle Int. 2004;25:19–26.CrossRefPubMed Wickman AM, Pinzur MS, Kadanoff R, Juknelis D. Health-related quality of life for patients with rheumatoid arthritis foot involvement. Foot Ankle Int. 2004;25:19–26.CrossRefPubMed
13.
go back to reference Williams A, Nester C, Ravey M. Rheumatoid arthritis patients’ experiences of wearing therapeutic footwear - a qualitative investigation. BMC Musculoskelet Disord. 2007;8:104.CrossRefPubMedPubMedCentral Williams A, Nester C, Ravey M. Rheumatoid arthritis patients’ experiences of wearing therapeutic footwear - a qualitative investigation. BMC Musculoskelet Disord. 2007;8:104.CrossRefPubMedPubMedCentral
16.
go back to reference Williams AE, Davies S, Graham A, Dagg A, Longrigg K, Lyons C, Bowen C. Guidelines for the management of the foot health problems associated with rheumatoid arthritis. Musculoskeletal Care. 2011;9:86–92. doi:10.1002/msc.200.CrossRefPubMed Williams AE, Davies S, Graham A, Dagg A, Longrigg K, Lyons C, Bowen C. Guidelines for the management of the foot health problems associated with rheumatoid arthritis. Musculoskeletal Care. 2011;9:86–92. doi:10.​1002/​msc.​200.CrossRefPubMed
18.
go back to reference Graham AS, Williams AE. Foot health education for people with rheumatoid arthritis: ’… a game of chance…’ - a survey of patients’ experiences. Musculoskeletal Care. 2016;14:37–46. doi:10.1002/msc.1111.CrossRefPubMed Graham AS, Williams AE. Foot health education for people with rheumatoid arthritis: ’… a game of chance…’ - a survey of patients’ experiences. Musculoskeletal Care. 2016;14:37–46. doi:10.​1002/​msc.​1111.CrossRefPubMed
20.
go back to reference Fautrel B, Pham T, Gossec L, Combe B, Flipo R, Goupille P, et al. Role and modalities of information and education in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion. Joint Bone Spine. 2005;72:163–70.CrossRefPubMed Fautrel B, Pham T, Gossec L, Combe B, Flipo R, Goupille P, et al. Role and modalities of information and education in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion. Joint Bone Spine. 2005;72:163–70.CrossRefPubMed
22.
go back to reference Steward K, Land M. Perceptions of patients and professionals on rheumatoid arthritis care. A consultancy report by the Kings Fund for the Rheumatology Futures Group. London: The Kings Fund; 2009. Steward K, Land M. Perceptions of patients and professionals on rheumatoid arthritis care. A consultancy report by the Kings Fund for the Rheumatology Futures Group. London: The Kings Fund; 2009.
24.
go back to reference Beatty P. The dynamics of cognitive interviewing. In: Presser S, Rothgeb J, Couper M, Lessler J, Martin M, Martin J, et al., eds. Methods for testing and evaluating questionnaires. New York: John Wiley and Sons Inc; 2004. Beatty P. The dynamics of cognitive interviewing. In: Presser S, Rothgeb J, Couper M, Lessler J, Martin M, Martin J, et al., eds. Methods for testing and evaluating questionnaires. New York: John Wiley and Sons Inc; 2004.
25.
go back to reference Willis G. Cognitive Interviewing. A Tool for Improving Questionnaire Design. Thousand Oaks: Sage Publishing Inc; 2005. Willis G. Cognitive Interviewing. A Tool for Improving Questionnaire Design. Thousand Oaks: Sage Publishing Inc; 2005.
26.
go back to reference Reja U, Manfreda K, Hlebec V, Vehovar V. Open-ended versus closed-ended questions in web questionnaires: advances in methodology and statistics. Metodoloski zvezki. 2003;19:159–77. Reja U, Manfreda K, Hlebec V, Vehovar V. Open-ended versus closed-ended questions in web questionnaires: advances in methodology and statistics. Metodoloski zvezki. 2003;19:159–77.
27.
go back to reference Sue V, Ritter L. Conducting Online Surveys. 2nd ed. Thousand Oaks: Sage Publications, Inc; 2012. Sue V, Ritter L. Conducting Online Surveys. 2nd ed. Thousand Oaks: Sage Publications, Inc; 2012.
28.
go back to reference Redmond AC, Waxman R, Helliwell PS. Provision of foot health services in rheumatology in the UK. Rheumatology (Oxford). 2006;45:571–6.CrossRef Redmond AC, Waxman R, Helliwell PS. Provision of foot health services in rheumatology in the UK. Rheumatology (Oxford). 2006;45:571–6.CrossRef
31.
go back to reference Drăgoi RG, Ndosi M, Sadlonova M, Hill J, Duer M, Graninger W, et al. Patient education, disease activity and physical function: can we be more targeted? A cross sectional study among people with rheumatoid arthritis, psoriatic arthritis and hand osteoarthritis. Arthritis Res Ther. 2013;15:R156. doi:10.1186/ar4339.CrossRefPubMedPubMedCentral Drăgoi RG, Ndosi M, Sadlonova M, Hill J, Duer M, Graninger W, et al. Patient education, disease activity and physical function: can we be more targeted? A cross sectional study among people with rheumatoid arthritis, psoriatic arthritis and hand osteoarthritis. Arthritis Res Ther. 2013;15:R156. doi:10.​1186/​ar4339.CrossRefPubMedPubMedCentral
32.
go back to reference Hjelm K, Nyberg P, Apelqvist J. Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions. J Adv Nurs. 2002;40:673–84.CrossRefPubMed Hjelm K, Nyberg P, Apelqvist J. Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions. J Adv Nurs. 2002;40:673–84.CrossRefPubMed
33.
go back to reference Semple R, Newcombe L, Finlayson G, Hutchison C, Forlow J, Woodburn J. The FOOTSTEP self-management foot care programme: are rheumatoid arthritis patients physically able to participate? Musculoskeletal Care. 2009;7:57–65. doi:10.1002/msc.142.CrossRefPubMed Semple R, Newcombe L, Finlayson G, Hutchison C, Forlow J, Woodburn J. The FOOTSTEP self-management foot care programme: are rheumatoid arthritis patients physically able to participate? Musculoskeletal Care. 2009;7:57–65. doi:10.​1002/​msc.​142.CrossRefPubMed
34.
go back to reference Hill J, Tennant A, Adebajo A. Further development of an educational needs assessment tool (ENAT) for patients with rheumatoid arthritis. Arthritis Rheum. 2004;50:S274–5. Hill J, Tennant A, Adebajo A. Further development of an educational needs assessment tool (ENAT) for patients with rheumatoid arthritis. Arthritis Rheum. 2004;50:S274–5.
37.
go back to reference Kääriäinen M, Kukkurainen ML, Kyngäs H, Karppinen L. Improving the quality of rheumatoid arthritis patients’ education using written information. Musculoskeletal Care. 2011;9:19–24. doi:10.1002/msc.192.CrossRefPubMed Kääriäinen M, Kukkurainen ML, Kyngäs H, Karppinen L. Improving the quality of rheumatoid arthritis patients’ education using written information. Musculoskeletal Care. 2011;9:19–24. doi:10.​1002/​msc.​192.CrossRefPubMed
38.
go back to reference Hill J, Bird H. The development and evaluation of a drug information leaflet for patients with rheumatoid arthritis. Rheumatology (Oxford). 2003;42:66–70.CrossRef Hill J, Bird H. The development and evaluation of a drug information leaflet for patients with rheumatoid arthritis. Rheumatology (Oxford). 2003;42:66–70.CrossRef
Metadata
Title
A survey of people with foot problems related to rheumatoid arthritis and their educational needs
Authors
Andrea S. Graham
John Stephenson
Anita E. Williams
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2017
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-017-0193-6

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