Perceptions of foot health services from the perspective of patients with rheumatoid arthritis in Finland.

BACKGROUND: Foot health services for people with rheumatoid arthritis (RA) are an important part of their comprehensive care. However, little is known about the perceptions of people with RA have about foot health services. This study aimed to explore how people with RA perceive foot health services. METHODS: A descriptive cross-sectional survey design was applied. The electronic survey data were collected in April 2023 from people with RA through a national patients' association (N = 2400, response rate 24%, n = 565). The statistical data were analysed using descriptive statistics and textual data with thematic analysis. RESULTS: Most of the respondents (n = 322, 59%) had used foot health services provided by chiropodist or podiatrist. Those who had used services were mostly satisfied but considered patient education about foot health insufficient. One third reported no visits to foot health services at all because of personal and health service system-related factors. CONCLUSIONS: Those people with RA who have access to foot health services value and appreciate the services. However, many people with RA do not use foot health services because they perceive availability of such services limited and thus unequal and hard to access. There is a need to develop foot health services for people with RA so that they are easy to access, correspond to their foot health needs and have seamless care paths at different levels of the health care system.

How to Measure Foot Self-Care? A Methodological Review of Instruments.

Foot self-care is an important element of caring for and promoting foot health. However, little is known about the validity and reliability of existing foot self-care instruments. The purpose of this review is to describe and analyze the focus, content, and psychometric evidence of existing instruments for measuring foot self-care. A methodological review of three international scientific databases-Medline (PubMed), CINAHL (Ebsco), and Embase-was conducted in May 2022. The search produced 3520 hits, of which 53 studies were included in the final analysis based on a two-phase selection process. A total of 31 instruments were identified, of which six were observed to have been used more than once. Subsequently, the methodological quality of these six instruments was evaluated. It is noted that although a considerable variety of instruments are used in measuring foot self-care, only a small proportion are used consistently. In general, the psychometric testing instruments seem to primarily focus on analyzing content validity and homogeneity. In the future, comprehensive testing of instrument psychometrics could enhance the cumulative evidence of the methodological quality of these instruments. Furthermore, researchers and clinicians can use the information in this review to make informed choices when selecting an instrument for their purposes.

Experiences of foot health in patients with rheumatoid arthritis: a qualitative study.

PURPOSE: The aim of the study was to explore the experiences of foot health and the factors that hinder or facilitate foot health self-care in patients with RA. MATERIALS AND METHODS: A descriptive qualitative study design was used. Individual interviews were conducted with patients who had been diagnosed with RA (n = 20). The interview data were analysed using inductive content analysis. RESULTS: The participants highly valued their foot health. The factors that hindered their foot health included physical characteristics (such as the progression of RA), personal traits (such as lack of motivation), inequalities in access to professional foot care and problems with finding suitable shoes. The factors that facilitated their foot health included professional care, physical activity and practising foot self-care. CONCLUSIONS: Patients with RA value their foot health. It is important to identify the factors that hinder or facilitate this in order to support their rehabilitation and respond to their foot-health needs. Patients' foot health should be promoted, and equal access to professional foot care should be provided.Implications for rehabilitationActive foot self-care supported by professional health are facilitating factors for foot health.Maintaining and promoting physical activity is integral part of foot health.Regular assessments of foot health in patients with RA in addition to an evaluation of their footwear and education about caring for their own feet is needed.