Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.
Clin Rheumatol. 2011 Dec;30(12):1611-5. doi: 10.1007/s10067-011-1784-4. Epub 2011 Jun 10.
The vascular and cutaneous alterations evident in systemic sclerosis/scleroderma (SSc) place the foot at risk of ulceration. The UK Podiatry Rheumatic Care Association (PRCA)/Arthritis and Musculoskeletal Alliance standards of care recommend that all people with SSc should receive at least basic information about their foot health, and that those with foot problems should have access to self-management advice and care where needed. The aim of this study was to evaluate foot health services offered in Leeds (UK) for people with SSc, against nationally agreed standards of care. Ninety-one consecutive patients with SSc were selected from either the connective tissue disease outpatient clinic (n = 70) or the specialist rheumatology foot health clinic (n = 21) at Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust. All the patients completed a disease-specific audit tool developed by the UK PRCA that evaluates provision of foot health care for patients with SSc. Sixty-one patients (67%) reported having had foot problems at some point in time and 54 (59%) had current foot problems. Of these 54 patients, 17 (32%) had not received any foot care. Only 36 (39%) of the 91 patients had received any foot health information. This audit demonstrates that patients with SSc have a relatively high prevalence of self-reported foot problems. Foot health care and information are inadequate for people with SSc and foot problems, and preventative information is almost non-existent. Improved foot health information will better empower patients to self-manage low risk problems, and help identify high risk problems which require specialist care.
系统性硬化症/硬皮病（SSc）患者的血管和皮肤改变使足部容易发生溃疡。英国足病风湿病护理协会（PRCA）/关节炎和肌肉骨骼联盟的护理标准建议，所有 SSc 患者都应至少获得有关其足部健康的基本信息，而有足部问题的患者应在需要时获得自我管理建议和护理。本研究旨在评估利兹（英国）为 SSc 患者提供的足部健康服务是否符合国家护理标准。从利兹教学医院 NHS 信托基金查佩尔·阿勒顿医院的结缔组织疾病门诊（n=70）或专科风湿病足部健康诊所（n=21）中选择了 91 名连续 SSc 患者。所有患者都完成了由英国 PRCA 开发的专门针对 SSc 患者足部保健服务的评估的疾病特异性审核工具。61 名患者（67%）报告在某个时间点有过足部问题，54 名（59%）有当前的足部问题。在这 54 名患者中，有 17 名（32%）未接受任何足部护理。只有 91 名患者中的 36 名（39%）接受过任何足部健康信息。该审核表明，有 SSc 的患者自我报告的足部问题患病率相对较高。有足部问题的 SSc 患者的足部保健和信息不足，预防信息几乎不存在。改善足部健康信息将更好地增强患者自我管理低风险问题的能力，并有助于识别需要专科护理的高风险问题。
