Validation of the Healthy Foot Screen: A Novel Assessment Tool for Common Clinical Abnormalities

Abstract

Foot health is a key component of general health and well-being. Nevertheless, feet are often overlooked by healthcare providers and patients. Common foot problems include infections or inflammatory conditions, abnormal nail disorders (eg, onychomycosis), structural bony abnormalities, circulation disorders, and other conditions. The development of an easy-to-use, rapid, clinical tool to assess foot health can facilitate primary care provider recognition and treatment of common foot problems. This study ascertained interrater item reliability and validity from the preliminary version of one such tool called the Healthy Foot Screen.A total of 18 patients from a community dermatology clinic were individually screened by 11 interprofessional healthcare assessors using the preliminary tool. The assessors included a dermatologist/internist, family physicians, nurses, and podiatrists. The initial draft of the Healthy Foot Screen was created through an extensive literature review, complemented by the clinical judgment of the study team. Cronbach α was calculated for each item to determine interrater reliability. A minimum value of 0.6 was set for an item to be included in the final tool. Where applicable, scores for each item on the screen were calculated for right and left lower limbs and then averaged. Assessors were asked to complete a short survey.Interrater reliability scores for items on the screen were as follows: diabetes and smoking, 1.0; neuropathy, 0.988; palpable foot pulse, 0.916; abnormal fourth to fifth toe web space, 0.905; previous ulcer/amputation, 0.869; pitting edema, 0.872; bony abnormality, 0.804; dry bottom of foot, 0.799; toenail infection, 0.793; other spots/lesions,0.688; and red areas/blisters/pustules, 0.659. Generally, assessors found the tool easy to use, although some areas for improvement were noted.The Healthy Foot Screen can facilitate primary care provider diagnosis and treatment of common foot problems.

<p>Determinants of Diabetic Foot Ulcer Among Adult Patients with Diabetes Attending the Diabetic Clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: Unmatched Case–Control Study</p>

“…Structured questionnaire adapted from different similar literature, [7][8][9][18][19][20] and standard evaluation tools for diabetic foot ulcers [21][22][23][24] were used to collect data. An intervieweradministered structured questionnaire and medical chart reviewing were carried out to collect data from the cases and controls.…”

Self-Care Planning and Sanitary Education in the Prevention of the Diabetic Foot

“…Below is a table that shows the search strategy used to select the 37 selected articles (Table 1): The results obtained show how a PD prevention program should contemplate [10][11][12]: Initial evaluation: carry out an anamnesis indicating the type of DM, personal and family history, smoking and alcohol consumption, lifestyle or eating habits [13][14][15][16][17][18][19][20][21][22][23]. Give information about nutrition, exercise, and illness, and review drug treatment and care plan [16,17,19].…”

“…Give information about nutrition, exercise, and illness, and review drug treatment and care plan [16,17,19]. Annual physical examination: BMI, blood pressure, and foot examination, in which a review of the skin, onychopathies, structural deformities, presence of edema, measurement of temperature, and presence of pain is carried out [7,[13][14][15][16]]. Vascular examination of the feet: anamnesis to determine the existence or not of intermittent claudication, palpation of pediatric, tibial, popliteal, and femoral pulses, and an ankle-brachial index test (ABI) are carried out to indicate the degree of ischemia [24][25][26][27][28][29].…”

Intervention study of a foot‐care programme enhancing knowledge and practice among nurses and care workers at in‐home service providers

“…In Japan, licensed podiatrists and/or podologists do not exist, though there are medical professionals or foot‐care workers who have some form of training certificates. Factors such as lack of foot‐care education for clients as well as for nurses and care workers, transport access (Syed, Gerber, & Sharp, 2013; Varela et al, 2019), perception of foot‐care (Chan et al, 2012; Persaud et al, 2018) and lack of physicians with foot specialty hinder referrals to doctors with extensive knowledge of foot and foot‐care. The possibility of fungal infections occurring on the foot (Suzuki, Mano, Furuya, & Fujitani, 2017) suggests the need for not only nurses or care workers to properly examine the skin and nail of the foot when rendering in‐home services but also doctors.…”