Foot health education for people with rheumatoid arthritis — some patient perspectives

Abstract

BackgroundPatient 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.MethodA 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.ConclusionsThis 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.

Foot Health Education for People with Rheumatoid Arthritis: '…. A Game of Chance…' – A Survey of Patients' Experiences

“…These can be achieved with early access to foot health assessment, and management which includes foot orthoses, therapeutic footwear (Arthritis and Rheumatism Musculoskeletal Alliance, ; National Institute for Clinical Excellence, ), and the care of nail and skin problems, together with patient education on how to contribute to this management (Williams et al, ). As patient education for people with RA has a positive effect in relation to their general disease management and overall health (Albano et al, ; Fautrel et al, ), foot health education (FHE) is also recognized as being essential (Graham et al, 2012a,b, Podiatric Rheumatic Care Association, ; Williams et al, ). Figure outlines the general aspects of foot health that healthcare professionals should aim to provide, depending on the needs of the person with RA and based on current guidelines (North West Podiatry Clinical Effectiveness Group, ).…”

Understanding the physical activity promotion behaviours of podiatrists: A qualitative study

“…However, the practice of tailoring advice as opposed to adhering to a standard message has been associated with increases in physical activity levels in the short-term [35], so such tailoring may be desirable. The tailoring of advice to the patient has also been advocated in diabetic education [39,40] and foot health education for patients with rheumatoid arthritis [41].…”

Rheumatic Diseases

“…Negotiations with the patient on balancing the risks and benefits of an intervention will be greatly affected by the patient' s priorities for treatment. Patients' perceptions / knowledge and expectations in relation to their presenting symptoms also need to be ascertained in order to create appropriate dialogue and understanding and engagement with interventions and advice (Graham et al 2012a(Graham et al , 2012b.…”

“…Lorig et al (2005) and Kjeken et al (2006) demonstrated that people with RA who are actively involved in their disease management have better outcomes, improved self-efficacy, less pain and reduced incidence of depression. In relation to foot problems, it has been recommended that patientcentred education should be provided to enable patients to make informed choices about their footcare (Graham et al 2012a(Graham et al , 2012bWilliams et al 2011).…”

“…However, two qualitative studies have highlighted what footspecific patient education should be and how it should be delivered from both the practitioner' s and patient' s perspective (Graham et al 2012a(Graham et al , 2012b. These two studies suggest that patient education encompasses information about the disease and how it affects the feet, information about the effectiveness of interventions and advice on self-care.…”