Abstract
Hendry GJ, Turner DE, Lorgelly PK, Woodburn J. Room for improvement: patient, parent,
and practitioners' perceptions of foot problems and foot care in juvenile idiopathic
arthritis.
Objective
To explore the perceived impact of disease-related foot problems and foot care in
juvenile idiopathic arthritis (JIA) from the perspectives of patients, parents, pediatric
rheumatologists, and health professionals.
Design
A qualitative study using an interpretative phenomenological approach.
Setting
Outpatients department, public health service children's hospital.
Participants
Patients (N=15; 4 adult patients, 2 parents of children with JIA, 3 pediatric rheumatologists,
and 6 health professionals) from 2 National Health Service rheumatology centers (1
pediatric and 1 adult).
Interventions
Not applicable.
Main Outcome Measures
Qualitative outcomes were participants' perceptions elicited using semistructured
interviews (telephone or face-to-face) and focus groups using an interpretative phenomenological
approach. A data-driven inductive approach to coding and theme development was adopted
for transcript analysis.
Results
Participants volunteered to take part in a total of 7 interviews and 2 focus groups.
The analysis revealed 6 key themes related to the impact of foot problems and perceptions
of foot care from respective groups. These were the following: (1) pain, (2) mobility
impairment, (3) reduced ability to perform activities of daily living, (4) footwear
difficulties, (5) poor referral pathways/delayed access to care, and (6) lack of evidence
in support of conservative foot care.
Conclusions
Several areas for development of foot care services were identified including a need
for improved referral pathways, shorter waiting times for initial consultations, greater
attention to patient compliance, and a need for better evidence in support of customized
foot orthoses. Several key foot health-related outcomes were identified, which may
be of importance for measuring therapeutic response to foot-related interventions.
Key Words
List of Abbreviations:
FO (foot orthosis), IPA (interpretative phenomenological approach), JIA (juvenile idiopathic arthritis), RA (rheumatoid arthritis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 27, 2012
Footnotes
Supported by Arthritis Research UK (grant no. 18076, 17832).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Sep 7, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
