Redmond A C, Waxman R, Helliwell P S
Academic Unit of Musculoskeletal Disease, University of Leeds, UK.
Rheumatology (Oxford). 2006 May;45(5):571-6. doi: 10.1093/rheumatology/kei205. Epub 2005 Nov 30.
To determine the provision of foot health services in rheumatology for the UK and Northern Ireland.
Two hundred and sixteen rheumatology departments were surveyed by postal questionnaire. Questions covered the contribution of various disciplines to rheumatology out-patient clinics, and opinions on existing and potential services, with emphasis on foot health provision. Inter-regional variations were explored for eight UK regions.
Valid responses were received from 170 respondents (78.7% response rate). More than 80% of out-patient departments reported having rheumatology nurse specialists included in the staff mix but fewer than half used other allied health professionals, such as podiatrists. One quarter of the departments had access to a podiatrist and in 18% there was a foot health service dedicated to rheumatology. Awareness of guidelines for referral or of standards of foot care provision was very low (6%). There was high satisfaction with the adequacy of provision of footwear and insoles (81-87%) but low satisfaction with the adequacy of basic foot care (48-52%). Regional variation was extremely high for the provision of basic foot care (0-73%), the non-English regions reporting poorer provision of service.
Regional variation in the adequacy of foot health services was high and the non-English regions especially are failing to meet the foot health needs of rheumatology patients. Multidisciplinary care is generally well developed despite the composition of teams being highly variable. Fewer than half of rheumatologists reported that basic foot care needs were being met, although adequacy of provision of more advanced foot services is perceived to be better. The absence of nationally agreed standards and poor awareness of local standards may be detrimental to care in this patient group.
确定英国和北爱尔兰风湿病学领域足部健康服务的提供情况。
通过邮寄问卷对216个风湿病科进行了调查。问题涵盖了各学科对风湿病门诊的贡献，以及对现有和潜在服务的看法，重点是足部健康服务的提供。对英国八个地区的区域差异进行了探讨。
共收到170份有效回复（回复率为78.7%）。超过80%的门诊部门报告称其工作人员中有风湿病专科护士，但使用其他专职医疗人员（如足病医生）的部门不到一半。四分之一的部门能接触到足病医生，18%的部门设有专门针对风湿病的足部健康服务。对转诊指南或足部护理标准的知晓率非常低（6%）。对鞋类和鞋垫供应充足度的满意度较高（81%-87%），但对基本足部护理充足度的满意度较低（48%-52%）。基本足部护理的提供情况区域差异极大（0%-73%），非英语地区的服务提供情况较差。
足部健康服务充足度的区域差异很大，尤其是非英语地区未能满足风湿病患者的足部健康需求。尽管团队组成差异很大，但多学科护理总体发展良好。不到一半的风湿病医生报告称基本足部护理需求得到了满足，不过人们认为更高级足部服务的提供充足度更好。缺乏全国统一的标准以及对当地标准的知晓度低可能不利于该患者群体的护理。
